Community-associated MRSA finally gets to central New York

Abstract

In this issue of The Journal, Suryadevara et al calculate the pediatric population-based incidence and hospitalization-based prevalence of invasive Staphylococcus aureus infection from 1996 through 2006 at the University Hospital in Syracuse, which serves 14 counties in central New York state. Their data are useful because such denominators are infrequently used in the plethora of case series describing the decade's epidemic of community-associated methicillin-resistant S aureus (MRSA). The remarkable finding of this study and epidemiologic note is that MRSA has come late and seemingly less pervasively to New York state to date. Years after remarkable case loads mounted across the country – Los Angeles, Dallas, Houston, Corpus Christi, Chicago, Little Rock, Nashville, Baltimore, Philadelphia – in the latter 1990s, colleagues in New York City were unburdened by MRSA USA 300. The known risk factors early in the epidemic – crowding, lower socioeconomic status, underlying skin conditions, sports teams, jails – certainly were extant in New York. MRSA is catching up with New York. But curious geographic differences in MRSA prevalence, antibiotic susceptibility, and sharing of virulence factors with methicillin-sensitive S aureus (MSSA) are evident across the country and between cities in the same state, such as Buffalo (J Pediatr 2007;151:561-3) and Syracuse, New York. We hear less about transmissibility of bacteria than of viruses. Maybe we should hear more.