An Outbreak of Community-Onset Methicillin-ResistantStaphylococcus aureusSkin Infections in Southwestern Alaska

Abstract

Our findings indicate that the epidemiology of MRSA in rural southwestern Alaska has changed and suggest that the emergence of community-onset MRSA in this region was not related to spread of a hospital organism. Treatment guidelines were developed recommending that beta-lactam antimicrobial agents not be used as a first-line therapy for suspected S. aureus infections.

International Circumpolar Surveillance, An Arctic Network for the Surveillance of Infectious Diseases

“…In remote Alaskan villages, lack of ready access to laboratory confi rmation of bacterial pathogens may contribute to overuse of antimicrobial agents. In addition, the presence of antimicrobial drug-resistant bacterial clones has led to an increase in infections with multidrug-resistant S. pneumoniae (24,25), methicillin-resistant Staphylococcus aureus (13), and clarthromycin-and metronidazole-resistant H. pylori (14).…”

“…Despite these interventions, high rates of invasive diseases caused by bacterial pathogens such as Streptococcus pneumoniae (3)(4)(5), Haemophilus infl uenzae (6), Helicobacter pylori (7,8), and Mycobacterium tuberculosis (9)(10)(11)(12) continue to persist. In addition, the emergence of antimicrobial drug resistance among bacterial pathogens once easily treated with commonly used antibiotics (10,(13)(14)(15), the entrance of HIV into Arctic communities (10,16), and the specter of pandemic infl uenza or the sudden emergence and introduction of new viral pathogens such as severe acute respiratory syndrome (SARS) are of increasing concern to residents, governments, and public health authorities of all Arctic countries.…”

Ctriporin, a New Anti-Methicillin-Resistant Staphylococcus aureus Peptide from the Venom of the Scorpion Chaerilus tricostatus

“…It has become a primary cause of skin and soft tissue infections among persons without extensive exposure to professional healthcare (46). Such settings and skin-to-skin contact have become a risk factor, which will accelerate the transmission of MRSA in humans (4,9,16,25). MRSAinduced sepsis, endocarditis, pneumonia, and soft tissue infections are difficult to treat because of the limited range of effective antibiotics.…”

Methicillin-ResistantStaphylococcus aureusCarriage and Risk Factors for Skin Infections, Southwestern Alaska, USA

“…Nasal carriage of S. aureus is a known risk factor for these infections ( 1 – 3 ) and a common reservoir during skin and soft tissue infection outbreaks ( 4 – 6 ). Such outbreaks have occurred in community ( 7 – 10 ) settings, e.g., athletic team facilities ( 11 – 16 ), correctional facilities ( 13 , 17 ), and military basic training camps ( 18 , 19 ). Risk factors found in these community settings are frequent skin-to-skin contact ( 11 , 12 , 14 , 15 ), sharing of personal items without frequent cleaning ( 11 – 14 ), and MRSA carriage ( 18 , 20 ).…”

“…MRSA exhibiting the type IV staphylococcal cassette chromosome mec gene had become the predominant community strain in that region, accounting for 100% of S. aureus isolates from skin infections ( 7 , 8 ). Also, the USA400 strain is the predominant strain of CA-MRSA in this area, whereas USA300 is the predominant strain in most other areas of the United States ( 8 ).…”