Abstract
We compared characteristics of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft tissue infections (SSTIs) and CA-MRSA invasive disease identified in Minnesota from 2000 through 2003. A total of 586 patients with SSTIs and 65 patients with invasive disease were identified. Patients with invasive disease were more likely to be smokers (p = 0.03), and report a history of immunosuppressive therapy (p = 0.03), emphysema (p = 0.011), or injection drug use (p = 0.020) than were SSTI patients. Invasive disease isolates were less likely to be susceptible to ciprofloxacin (p = 0.002) and clindamycin (p = 0.001) and more likely to have healthcare-associated pulsed-field gel electrophoresis subtypes than SSTI isolates (p<0.001). Patients with invasive disease may have had healthcare exposures that put them at risk of acquiring healthcare-associated MRSA and which were not exclusion criteria in the CA-MRSA case definition. Continued surveillance of MRSA is needed to better characterize CA-MRSA infections.
Highlights
Methicillin-resistant Staphylococcus aureus (MRSA) was first reported in 1961 and was recognized as a nosocomial pathogen by the late 1960s [1,2]
Invasive disease patients were more likely to be male and more likely to have a history of underlying conditions than were soft tissue infections (SSTIs) patients
Invasive disease isolates were similar to HA-MRSA isolates in that they were resistant to additional antimicrobial drugs and were more likely to belong to a pulsed-field type (PFT) usually associated with HA-MRSA [7]
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) was first reported in 1961 and was recognized as a nosocomial pathogen by the late 1960s [1,2]. In the 1980s, MRSA infections were reported in persons who lacked traditional MRSA risk factors. These infections appeared to be acquired in the community and are known as community-associated (CA) MRSA infections. These infections have been reported worldwide [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18]. Most CA-MRSA infections resolve, but deaths from invasive CA-MRSA disease have been reported [8]. A subanalysis of CA-MRSA invasive disease patients and SSTI patients and isolates was conducted by using data collected from CA-MRSA prospective sentinel surveillance in Minnesota from 2000 through 2003
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