Abstract
Abstract Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are common in southwestern Alaska. Outbreak strains have been shown to carry the genes for Panton-Valentine leukocidin (PVL). To determine if carriage of PVL-positive CA-MRSA increased the risk for subsequent soft tissue infection, we conducted a retrospective cohort study by reviewing the medical records of 316 persons for 3.6 years after their participation in a MRSA nasal colonization survey. Demographic, nasal carriage, and antimicrobial drug use data were analyzed for association with skin infection risk. Skin infections were more likely to develop in MRSA carriers than in methicillin-susceptible S. aureus carriers or noncarriers of S. aureus during the first follow-up year, but not in subsequent years. Repeated skin infections were more common among MRSA carriers. In an area where PVL-containing MRSA is prevalent, skin infection risk was increased among MRSA nasal carriers compared with methicillin-susceptible S. aureus carriers and noncarriers, but risk differential diminished over time.
Highlights
Community-acquired methicillin-resistant Staphylococcus aureus (CA-Methicillin-resistant Staphylococcus aureus (MRSA)) infections are common in southwestern Alaska
Our goal was to assess the risk for subsequent skin infections among persons whose nares cultures were colonized with MRSA compared with those colonized with methicillin-susceptible S. aureus (MSSA), or those whose nares cultures were negative for S. aureus
In this study of a rural village in southwestern Alaska where MRSA was responsible for 86% of skin infections, we recruited a cohort of participants from a community setting to determine risk factors for the development of skin infections
Summary
Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are common in southwestern Alaska. To determine if carriage of PVL-positive CA-MRSA increased the risk for subsequent soft tissue infection, we conducted a retrospective cohort study by reviewing the medical records of 316 persons for 3.6 years after their participation in a MRSA nasal colonization survey. Little is known about the subsequent risk for skin and soft tissue infections among persons colonized with MRSA. This lack of information becomes a question of clinical significance because increasing numbers of MRSA case-cluster investigations include nasal colonization studies that identify persons as MRSA-colonized. We conducted a case–control study in 1 village in Alaska to assess risk factors for MRSA skin infections and evaluated nasal carriage among case–control participants and their household members [1]. Our goal was to assess the risk for subsequent skin infections among persons whose nares cultures were colonized with MRSA (carriers) compared with those colonized with methicillin-susceptible S. aureus (MSSA), or those whose nares cultures were negative for S. aureus (non–S. aureus carriers)
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