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Research:
Mark Gilbert, Judy MacDonald, Dan Gregson, Jennifer Siushansian, Kunyan Zhang, Sameer Elsayed, Kevin Laupland, Tom Louie, Karen Hope, Michael Mulvey, John Gillespie, Diane Nielsen, Virginia Wheeler, Marie Louie, Agnes Honish, Gloria Keays, and John Conly
Outbreak in Alberta of community-acquired (USA300) methicillin-resistant Staphylococcus aureus in people with a history of drug use, homelessness or incarceration
CMAJ 2006; 175: 149-154 [Abstract] [Full text] [PDF]
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[Read eLetter] Community acquired MRSA with no identified predisposing risk.
Jeevan P Marasinghe   (25 July 2006)

Community acquired MRSA with no identified predisposing risk. 25 July 2006
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Jeevan P Marasinghe

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Re: Community acquired MRSA with no identified predisposing risk.

jeevanmarasinghe{at}yahoo.com Jeevan P Marasinghe

Dear Sir, Methicillin resistant Staphylococcus aureus (MRSA)was once primarily a hospital acquired organism but now community acquired (CA)MRSA is causing outbreaks in vulnerable groups and otherwise healthy individuals.CA-MRSA in vulnerable groups such as people with histories of illicit drug use, homelessness or recent incarceration (1 ),prison inmates, low income communities, professional football players( 2)athletes(3), inmates at correctional facilities, military recruits and among tattoo recipients is known to have a high prevalence. But the absence of identified risk factors can not merely exempt patients from laborious surveillance and testing for MRSA since the prevalence of CA-MRSA without identified risk factors is increasing(4) and CA-MRSA is no longer just a cause of community acquired infections but has also emerged as a cause of health care associated infections(5 ),( 6).So Clinicians should consider CA-MRSA in their differential diagnosis for skin and soft tissue infections ,in patients who do not come with typical features suggestive of high vulnerability and this should have been mentioned in the interpretation of the study at the end.

Jeevan P Marasinghe, Registrar in Obstetrics and Gynecology, Professorial Unit, General Hospital (Teaching), Peradeniya, Sri Lanka.

Amarasinghe A A W, MD, Mcdonough, Georgia, USA.

References.

(1).Gilbert M et al Outbreak in Alberta of community acquired (USA 300) methicillin resistant staphylococcus aureus in people with a history of drug use homelessness or incarceration.CMAJ Jul 18, 2006; 175(2).

(2)Kasakova SV.A clone of methicillin resistant Staphylococcus aureus among professional football players N Engl J Med.2005 Feb 3; 352(5):468- 75.

(3).Centers for disease control and prevention (CDC)Methicillin resistant staphylococcus aureus skin infections among tattoo recipients –Ohio,Kentucky,and Vermont,2004-2005.MMWR Morb Mortal Wkly Rep.2006 Jun 23;55(24):677-9.

(4)Herold BC et al.Community acquired methicillin resistant Staphylococcus aureus in children with no identified predisposing risk.JAMA.1998 Feb 25; 279(8):593-8.

(5)Kourbatova EVet al .Emergence of community associated methicillin resistant Staphylococcus aureus USA 300 clone as a cause of health care associated infections among patients with prosthetic joint infections. Am J Infect Control.2005 Sep; 33(7):385-91.

(6)Enayet I et al.Community associated methicillin resistant Staphylococcus aureus causing chronic pneumonia.Clin Infect Dis.2006 Apr 1; 42(7):e57-60.

Conflict of Interest:

None declared