Community-associated methicillin-resistant Staphylococcus aureus skin infections in a religious community

• Published in: Epidemiology and infection Vol. 135; no. 3; pp. 492 - 501
• Main Authors: CORONADO, F., NICHOLAS, J. A., WALLACE, B. J., KOHLERSCHMIDT, D. J., MUSSER, K., SCHOONMAKER-BOPP, D. J., ZIMMERMAN, S. M., BOLLER, A. R., JERNIGAN, D. B., KACICA, M. A.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.04.2007
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antimicrobial agents; Antimicrobials; Bacteriology; Biological and medical sciences; Child; Child, Preschool; Cohort analysis; Cohort Studies; Community; Community-Acquired Infections - epidemiology; Community-Acquired Infections - prevention & control; Disease control; Disease Outbreaks; Disease prevention; Epidemics; Epidemiology; Families & family life; Female; Fundamental and applied biological sciences. Psychology; Health care; Humans; Hygiene; Infant; Infections; Infectious diseases; Male; Methicillin Resistance; Methicillin resistant staphylococcus aureus; Microbiology; Middle Aged; Miscellaneous; Nasal Mucosa - microbiology; Predisposing factors; Preventive medicine; Questionnaires; Religion; Risk factors; Short Report; Skin; Staphylococcal Infections - epidemiology; Staphylococcal Infections - prevention & control; Staphylococcal Skin Infections - epidemiology; Staphylococcal Skin Infections - prevention & control; Staphylococcus aureus; Staphylococcus infections; New York; Atlanta Georgia; United States > US; Human; Microbiology; Bacteria; Micrococcales; Micrococcaceae; Skin; Epidemiology; Staphylococcus aureus
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268806006960

In September 2004, an outbreak of community-associated methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTI) was reported among members of a religious community. We conducted a retrospective cohort study on all 175 community members; performed a nasal carriage survey, and environmental swab testing. We identified 24 MRSA cases (attack rate 14%). In multivariate analysis, sauna use [odds ratio (OR) 19·1, 95% confidence interval (CI) 2·7–206·1] and antimicrobial use within 12 months before infection (OR 11·7, 95% CI 2·9–47·6) were risk factors for infection. MRSA nasal carriage rate was 0·6% (1/174). Nine of 10 clinical isolates and an isolate from an administrative office within the community had the pulsed-field gel electrophoresis type USA300. Targeted hygiene improvement, wound care, and environmental cleaning were implemented. We describe the first reported outbreak of MRSA SSTI in a religious community. Adherence to appropriate personal and environmental hygiene might be critical factors in controlling transmission.