Community-Acquired Methicillin-Resistant Staphylococcus aureus Infections: A New Source for Nosocomial Outbreaks

Abstract

Over a 19-month period, 165 patients with 183 infections caused by community-acquired, methicillin-resistant Staphylococcus aureus were seen at Henry Ford Hospital in Detroit, Michigan. The proportion of community-acquired staphylococcal infections resistant to methicillin rose from 3 % in March 1980 to 38% in September 1981. Drug abuse, serious underlying illness, previous antimicrobial therapy, and previous hospitalization were all associated with the development of this infection. Concurrent with the community epidemic was a nosocomial epidemic of methicillin-resistant S. aureus infection, which accounted for 30.6% of all nosocomial staphylococcal infections in January 1981. Control measures that included isolation, discharge precautions for carriers, and eradication of employee carriage were effective in preventing nosocomial transmission. The prevalence of methicillin-resistant S. aureus carriage among employees was 0.7%. Methicillin-resistant S. aureus may originate in the community as well as in the hospital, and presents a threat to patients in both settings.

Methicillin-resistant staphylococci

“…Methicillin-resistant strains have become established outside the hospital, particularly among intravenous drug users (101,135,136).…”

Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in Finland

“…among Australian aboriginees, American Indians, and in certain areas in New Zealand, Tonga, and Samoa (72,95,160,272). Outbreaks of community MRSA have been described among intravenous drug users, members of a sports group, and families (150,152,239). One outbreak of gastroenteritis has also been attributed to a community MRSA (125).…”

Methicillin resistance in <i>Staphylococcus aureus</i>: a review of the molecular epidemiology, clinical significance and laboratory detection methods

“…4 In the 1980s, MRSA infections were reported in persons who had no previous hospitalization. 12 These infections appeared to be acquired in the community and were termed community-acquired MRSA (CA-MRSA) infections. Both healthcare-associated MRSA (HA-MRSA) and CA-MRSA infections have since been reported worldwide.…”

“…10 In the 1980s, MRSA emerged as a community-acquired pathogen causing infections in people without identifiable established risks. 12 These community-acquired MRSA infections, which were first noticed among intravenous drug addicts, have in recent times become increasingly being reported among infants and children, 13 and among individuals involved in intense contact sports 14 with attendant morbidity and considerable mortality.…”