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Methicillin-Resistant Staphylococcus aureus in the Community: New Battlefronts, or Are the Battles Lost?

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of nosocomial infections worldwide. Interpretation of community MRSA trends is problematical, in that the term is ill-defined, and related data are difficult to put into context. There are four relevant battlefronts, all of interest to risk assessment and prevention. These comprise the following: the issues relating to an increasing pool of patients with MRSA discharged from hospitals into the community; MRSA spreading to patients in nursing and residential homes; and MRSA spreading from patients and healthcare workers to others in the community. There are often difficulties in determining whether the fourth issue, MRSA arising apparently de novo in the community, is in fact due to one of these other fronts. All these battlefronts are important and not yet lost. However, we must agree on definitions and design-appropriate surveillance strategies, so that we can best inform prevention and control activities to contain these emerged or emerging problems.

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Corresponding author
Laboratory of Hospital Infection, Central Public Health Laboratory, 61, Colindale Ave, London NW9 5HT, England
References
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1. Jevons MP. Celbenin-resistant staphylococci. BMJ 1961;1:124.
2. Borowski J, Kamienska K, Rutecka I. Methicillin-resistant staphylococci. BMJ 1964;1:983.
3. Parker MT, Hewitt JH. Methicillin resistance in Staphylococcus aureus . Lancet 1970;1:800804.
4. Wu S, de Lencastre H, Tomasz A. Genetic organisation of the mecA region in methicillin-susceptible and methicillin-resistant Staphylococcus sciuri . J Bacteriol 1997;180:236242.
5. Matsuhashi M, Song MD, Ishino F, Wachi M, Doi M, Inoue M, et al. Molecular cloning of the gene of a penicillin-binding protein supposed to cause high resistance to β-lactam antibiotics in Staphylococcus aureus . J Bacteriol 1986;167:975980.
6. Centers for Disease Control and Prevention. Four pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus—Minnesota and North Dakota, 1997-1999. MMWR 1999;48:707710.
7. Ayliffe GAJ, Blemkinsop R, Cooke EM, Casewell MWC, Cookson BD, Cox RA, et al. Guidelines for the control of epidemic methicillin-resistant Staphylococcus aureus in elderly care and nursing homes. Report of a combined working party of the Hospital Infection Society and the British Society of Antimicrobial Chemotherapy. J Hosp Infect 1995;31:112.
8. Revised guidelines for the control of methicillin-resistant Staphylococcus aureus infections in hospitals. British Society for Antimicrobial Chemotherapy, Hospital Infection Society and the Infection Control Nurses Association. J Hosp Infect 1998;39:253290.
9. Hospital Infection Control 1999;October Issue.
10. Cookson BD, Peters B, Webster M, Phillips I, Rahman M, Noble W. Staff carriage of epidemic methicillin-resistant Staphylococcus aureus . J Clin Microbiol 1989;27:14711476.
11. Boyce JM. Are the epidemiology and microbiology of methicillin-resistant Staphylococcus aureus changing? JAMA 1998;279:623624.
12. Goetz A, Posey K, Fleming J, Jacobs S, Boody L, Wagener MM, et al. Methicillin-resistant Staphylococcus aureus in the community: a hospital-based study. Infect Control Hosp Epidemiol 1999;20:689691.
13. Kinsman OS, Mackenna R, Noble WC. Association between histocompatibility antigens (HLA) and nasal carriage of Staphylococcus aureus . J Med Microbiol 1983;16:215220.
14. Cookson BD, Phillips I. Methicillin-resistant staphylococci. J Appl Bacteriol 1990;69(suppl 19):55S70S.
15. Rahman A, Mackenzie D, Marples R, Cookson BD. Identification of MRSA incidents in hospitals. J Hosp Infect 1995;30:7678.
16. French G, Cheng AFB, Ling JML, Mo P Donnan S. Hong Kong strains of methicillin-resistant and methicillin-sensitive Staphylococcus aureus have similar virulence. J Hosp Infect 1990;15:117125.
17. Kerr S, Kerr GE, Mackintosh CA, Marples RR. A survey of methicillin-resistant Staphylococcus aureus affecting patients in England and Wales. J Hosp Infect 1990;16:3548.
18. Cookson BD. Nosocomial antimicrobial resistance surveillance. J Hosp Infect 1999;43(suppl):S97S103.
19. Marples RR, Cooke EM. Current problems with methicillin-resistant Staphylococcus aureus . J Hosp Infect 1988;11:381392.
20. Masterton RG, Coia JE, Notman AW, Kempton-Smith L, Cookson BD. Refractory methicillin-resistant Staphylococcus aureus carriage associated with contamination of the home environment. J Hosp Infect 1995;29:318319.
21. Cookson BD. Selective staphylococcal broth. J Clin Microbiol 1990;28:23802381.
22. Holiis RJ, Barr JL, Doebbeling BN, Pfaller MA, Wenzel RP. Familial carriage of methicillin-resistant Staphylococcus aureus and subsequent infection in a premature neonate. Clin Infect Dis 1995;21:328332.
23. Lindenmayer JM, Schoenfeld S, O'Grady R, Carney JK. Methicillin-resistant Staphylococcus aureus in a high school wrestling team and the surrounding community. Arch Intern Med 1998;158:895899.
24. Saravolatz LD, Markowitz N, Arking L, Pohlod MS, Fisher E, Arbor A. Methicillin-resistant Staphylococcus aureus . Ann Intern Med 1982;96:1116.
25. Moreno F, Crisp C, Jorgensen JH, Patterson JE. Methicillin-resistant Staphylococcus aureus as a community organism. Clin Infect Dis 1995;21:13081312.
26. Bloch KC, Gerberding JL. Sample size could limit the power of case-control studies for determining risk factors for community-acquired methicillin-resistant Staphylococcus aureus . Clin Infect Dis 1996;23:851852.
27. Layton MC, Hierholzer WJ, Patterson JE. The evolving epidemiology of methicillin-resistant Staphylococcus aureus at a university hospital. Infect Control Hosp Epidemiol 1995;16:1217.
28. Herold BC, Immergluck LC, Maranan MC, Lauderdale DS, Gaskin RE, Boyle-Vavra S, et al. Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk. JAMA 1998;279:593598.
29. Adcock PM, Pastor P, Medley F, Patterson JE, Murphy TV. Methicillin-resistant Staphylococcus aureus in two child care centers. J Infect Dis 1998;178:577580.
30. Shanin R, Johnson IL, Jamieson F. Methicillin-resistant Staphylococcus aureus in a child care centre following a case of disease. Arch Pediatr Adolesc Med 1999;153:864868.
31. Riley TV, Pearmen JW, Rouse II. Changing epidemiology of methicillin-resistant Staphylococcus aureus in Western Australia. Med J Aust 1995;163:412414.
32. Maguire GP, Arthur AD, Boustead PJ, Dwyer B, Currie BJ. Clinical experience and outcomes of community-acquired and nosocomial methicillin-resistant Staphylococcus aureus in a northern Australian hospital. J Hosp Infect 1998;38:273281.
33. Rings T, Findlay R, Lang S. Ethnicity and methicillin-resistant S aureus in South Auckland. N Z Med J 1998;111:151.
34. Collignon P. Increased incidence of methicillin-resistant strains of Staphylococcus aureus in the community. J Infect Dis 1999;179:1592.
35. Gross-Schulman S, Dassey D, Mascola L, Anaya C. Community-acquired methiculin-resistant Staphylococcus aureus . JAMA 1998;280:421422.
36. Stacey AR, Endersby KE, Chan PC, Marples RR. An outbreak of MRSA infection in a rugby football team. Brit J Sports Med 1998;32:153154.
37. Groos A, Naimi T, Wolsey D, Smith-Johnson K, Moore K, Cheek J. Emergence of community-acquired methicillin-resistant Staphylococcus aureus in a rural American Indian community. Presented at the 39th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy; September 26-29,1999; San Francisco, CA. Abstract 1230.
38. Embil J, Ramotar K, Romance L, Alfa M, Conly J, Cronk S, et al. Methicillin-resistant Staphylococcus aureus in tertiary care institutions on the Canadian Prairies 1990-1992. Infect Control Hosp Epidemiol 1994;15:646651.
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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