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Surveillance for severe community-associated methicillin-resistant Staphylococcus aureus infection

  • P. WIERSMA (a1) (a2), M. TOBIN D'ANGELO (a2), W. R. DALEY (a3), J. TUTTLE (a2), K. E. ARNOLD (a2), S. M. RAY (a4), J. L. LADSON (a5), S. N. BULENS (a2) and C. L. DRENZEK (a2)...

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has rapidly emerged in the USA as a cause of severe infections in previously healthy persons without traditional risk factors. We describe the epidemiology of severe CA-MRSA disease in the state of Georgia, USA and analyse the risk of death associated with three different clinical syndromes of CA-MRSA disease – pneumonia, invasive disease, and skin and soft-tissue infections (SSTIs). A total of 1670 cases of severe CA-MRSA disease were reported during 2005–2007. The case-fatality rate was 3·4%; sex and race of fatal and non-fatal cases did not differ significantly. While CA-MRSA pneumonia and invasive disease were less common than SSTIs, they were about 15 times more likely to result in death [risk ratio 16·69, 95% confidence interval (CI) 10·28–27·07 and 13·98, 95% CI 7·74–25·27, respectively]. When controlling for age and the presence of other clinical syndromes the odds of death in patients manifesting specific severe CA-MRSA syndromes was highest in those with pneumonia (odds ratio 11·34). Possible risk factors for severe CA-MRSA SSTI and pneumonia included the draining of lesions without medical assistance and an antecedent influenza-like illness.

Corresponding author
*Author for correspondence: Dr P. Wiersma, 5120 Geneva PI, Dulles, VA 20189, USA. (Email:
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1. TS Naimi , Comparison of community and health care associated methicillin-resistant Staphylococcus aureus infection. Journal of the American Medical Association 2003; 290: 29762984.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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