Epidemiology and Infection



Community-associated methicillin-resistant Staphylococcus aureus skin infections in a religious community 1


F. CORONADO a1a3c1, J. A. NICHOLAS a3, B. J. WALLACE a3, D. J. KOHLERSCHMIDT a4, K. MUSSER a4, D. J. SCHOONMAKER-BOPP a4, S. M. ZIMMERMAN a5, A. R. BOLLER a5, D. B. JERNIGAN a2 and M. A. KACICA a3
a1 Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
a2 National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
a3 Bureau of Communicable Disease Control, New York State Department of Health, NY, USA
a4 Wadsworth Center, New York State Department of Health, NY, USA
a5 Esopus Medical, NY, USA

Article author query
coronado f   [PubMed][Google Scholar] 
nicholas ja   [PubMed][Google Scholar] 
wallace bj   [PubMed][Google Scholar] 
kohlerschmidt dj   [PubMed][Google Scholar] 
musser k   [PubMed][Google Scholar] 
schoonmaker-bopp dj   [PubMed][Google Scholar] 
zimmerman sm   [PubMed][Google Scholar] 
boller ar   [PubMed][Google Scholar] 
jernigan db   [PubMed][Google Scholar] 
kacica ma   [PubMed][Google Scholar] 

Abstract

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.

(Accepted May 16 2006)
(Published Online July 26 2006)


Correspondence:
c1 Centers for Disease Control and Prevention, 1600 Clifton Rd, NE MS E-92, Atlanta, GA 30333, USA. (Email: fcoronado@cdc.gov)


Footnotes

1 The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.



Metrics