title: Incidence of Community-associated Methicillin-resistant Staphylococcus aureus Infections in a Regional Hospital.
abstract: OBJECTIVE
  Since the early 2000s, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections among the community of people lacking known healthcare risk factors has increased. This MRSA infection is referred to as community-associated MRSA (CA-MRSA) infection and is distinct from hospital-associated MRSA (HA-MRSA) infection, which occurs among people with known healthcare risk factors. Understanding the epidemiology of CA-MRSA infections is critical; however, this has not been investigated in detail in Japan. Our objective was to investigate the incidence of CA-MRSA infections in a regional hospital.
  
  
  METHODS
  We investigated CA-MRSA isolates and infections in a rural regional hospital by reviewing medical records of one year. Infections were classified as CA-MRSA if no established risk factors were identified.
  
  
  RESULTS
  During 2008, 31 Staphylococcus aureus (S. aureus) isolates were detected in 29 unique patients, with 1 methicillin-sensitive S. aureus (MSSA) isolates obtained from 19 patients (66%) and MRSA obtained from 10 patients (34%). In the 10 patients with MRSA, the number of HA-MRSA and CA-MRSA cases were nine (32% of patients with S. aureus isolates) and one (3%), respectively. The patient with CA-MRSA was diagnosed with cellulitis due to CA-MRSA. All nine patients with HA-MRSA exhibited colonization.
  
  
  CONCLUSIONS
  We observed a CA-MRSA case in a regional hospital in Japan, suggesting that incidence trends of CA-MRSA should be considered in future research and treatment.
authors: Department of Healthcare Systems Research, Hokkaido University Graduate School of Medicine, Japan.
authors: Hidenobu
authors: H
authors: Kawabata
authors: Department of Healthcare Systems Research, Hokkaido University Graduate School of Medicine, Japan.
authors: Manabu
authors: M
authors: Murakami
authors: Department of Healthcare Systems Research, Hokkaido University Graduate School of Medicine, Japan.
authors: Kengo
authors: K
authors: Kisa
authors: Department of Healthcare Systems Research, Hokkaido University Graduate School of Medicine, Japan.
authors: Masaji
authors: M
authors: Maezawa
keywords: colonization; community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA); hospital-associated MRSA (HA-MRSA); incidence; skin and soft tissue infection (SSTI)
references: J Rural Med. 2010;5(1):140-3
references: 25649545
references: Am J Public Health. 2010 Sep;100(9):1777-83
references: 20634456
references: J Clin Microbiol. 2007 Jun;45(6):1705-11
references: 17392441
references: JAMA. 2003 Dec 10;290(22):2976-84
references: 14665659
references: Epidemiol Infect. 2009 Dec;137(12):1674-8
references: 19366491
references: J Infect Dis. 2008 May 1;197(9):1235-43
references: 18422435
references: Plast Reconstr Surg. 2008 Oct;122(4):120e-7e
references: 18827629
references: J Infect Chemother. 2008 Dec;14(6):439-41
references: 19089559
references: Arch Intern Med. 2007 May 28;167(10):1026-33
references: 17533205
references: J Infect Chemother. 2010 Aug;16(4):292-7
references: 20306108
references: J Clin Microbiol. 2005 Jul;43(7):3364-72
references: 16000461
references: J Hosp Infect. 2005 Sep;61(1):62-7
references: 15893854
references: Lancet Infect Dis. 2009 Jun;9(6):384-92
references: 19467478
references: N Engl J Med. 2006 Aug 17;355(7):666-74
references: 16914702
references: N Engl J Med. 2005 Apr 7;352(14):1436-44
references: 15814879