2002
DOI: 10.1086/338069
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Population-Based Community Prevalence of Methicillin-Resistant Staphylococcus aureus in the Urban Poor of San Francisco

Abstract: The study objective was to determine the prevalence and risk factors for nasal colonization with Staphylococcus aureus and methicillin resistance among the urban poor and to compare antibiotic resistance and genetic similarity to concurrently collected clinical isolates of methicillin-resistant S. aureus (MRSA). A population-based community sample of 833 homeless and marginally housed adults were cultured and compared with 363 clinical isolates of MRSA; 22.8% of the urban poor were colonized with S. aureus. Of… Show more

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Cited by 220 publications
(181 citation statements)
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“…Nevertheless, our results showed an unusually high prevalence of resistance to erythromycin (93%), in contrast to other reports of 69% in Alaska (1) and 61% in the San Francisco urban poor study (9). Further, unlike other studies, in our data the prevalence of MRSA strains expressing iMLSB was relatively low (10.2%) (16), suggesting that clindamycin remains one option for effective antimicrobial treatment in our community.…”
Section: Discussioncontrasting
confidence: 93%
“…Nevertheless, our results showed an unusually high prevalence of resistance to erythromycin (93%), in contrast to other reports of 69% in Alaska (1) and 61% in the San Francisco urban poor study (9). Further, unlike other studies, in our data the prevalence of MRSA strains expressing iMLSB was relatively low (10.2%) (16), suggesting that clindamycin remains one option for effective antimicrobial treatment in our community.…”
Section: Discussioncontrasting
confidence: 93%
“…Among the CA-MRSA strains, the most common SCCmec type was type IV (10 isolates) followed by type V (7 isolates), a finding similar to that of Dejing et al [25]. These results suggest that CA-and HA-MRSA are likely to coexist in our hospitals, as previously reported in the United States [26]. In this study, the SCCmec types correlated well with the major antibiotic susceptibility patterns.…”
Section: Discussionsupporting
confidence: 90%
“…21 Outbreaks or a high prevalence of CA-MRSA infections have, however, been previously found in marginalized populations (prison inmates, 4 drug-using and homeless people, 22,23 and low-income communities 24 ), where these strains may become endemic and difficult to control. 25 Ongoing surveillance of CA-MRSA (and USA300) in the CHR has identified a further 310 infections up to the end of 2005 (8-34 cases/mo), with at least 73% occurring in the high-risk or transient population, which suggests that the strain has become endemic in this setting. Transmission within these populations has been attributed to factors that are environmental (e.g., crowded living conditions, such as in homeless shelters or jails), social (e.g., belonging to drugusing networks) and behavioural (e.g., poor personal hygiene).…”
Section: Other Risk Factormentioning
confidence: 99%