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Community-associated methicillin-resistant Staphylococcus aureus skin infections in a religious community

  • F. CORONADO (a1) (a2), J. A. NICHOLAS (a2), B. J. WALLACE (a2), D. J. KOHLERSCHMIDT (a3), K. MUSSER (a3), D. J. SCHOONMAKER-BOPP (a3), S. M. ZIMMERMAN (a4), A. R. BOLLER (a4), D. B. JERNIGAN (a5) and M. A. KACICA (a2)
  • DOI:
  • Published online: 26 July 2006

In September 2004, an outbreak of community-associated methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTI) was reported among members of a religious community. We conducted a retrospective cohort study on all 175 community members; performed a nasal carriage survey, and environmental swab testing. We identified 24 MRSA cases (attack rate 14%). In multivariate analysis, sauna use [odds ratio (OR) 19·1, 95% confidence interval (CI) 2·7–206·1] and antimicrobial use within 12 months before infection (OR 11·7, 95% CI 2·9–47·6) were risk factors for infection. MRSA nasal carriage rate was 0·6% (1/174). Nine of 10 clinical isolates and an isolate from an administrative office within the community had the pulsed-field gel electrophoresis type USA300. Targeted hygiene improvement, wound care, and environmental cleaning were implemented. We describe the first reported outbreak of MRSA SSTI in a religious community. Adherence to appropriate personal and environmental hygiene might be critical factors in controlling transmission.

Corresponding author
Centers for Disease Control and Prevention, 1600 Clifton Rd, NE MS E-92, Atlanta, GA 30333, USA. (Email:
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The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
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Epidemiology & Infection
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