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

Published online by Cambridge University Press:  26 July 2006

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

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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.

Type
Research Article
Copyright
2006 Cambridge University Press

Footnotes

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.