Epidemics of Community-Associated Methicillin-Resistant Staphylococcus aureus in the United States: A Meta-Analysis

Abstract

Staphylococcus aureus is the most frequent cause of skin and soft tissue infections in humans. Methicillin-resistant strains of S. aureus (MRSA) that emerged in the 1960s presented a relatively limited public health threat until the 1990s, when novel community-associated (CA-) MRSA strains began circulating. CA-MRSA infections are now common, resulting in serious and sometimes fatal infections in otherwise healthy people. Although some have suggested that there is an epidemic of CA-MRSA in the U.S., the origins, extent, and geographic variability of CA-MRSA infections are not known. We present a meta-analysis of published studies that included trend data from a single site or region, and derive summary epidemic curves of CA-MRSA spread over time. Our analysis reveals a dramatic increase in infections over the past two decades, with CA-MRSA strains now endemic at unprecedented levels in many US regions. This increase has not been geographically homogeneous, and appears to have occurred earlier in children than adults.

Changing Susceptibility of Staphylococcus aureus in a US Pediatric Population

“…15,30,36 Additionally, a recent meta-analysis suggested that the communityassociated MRSA epidemic may have peaked earlier in children than in adults. 37 Evaluation of respiratory, sterile site, and other non-SSTIs cultures suggest that MSSA predominates in these infections as compared with SSTIs. Although sterile site isolates represented a minority of infections in this study, these isolates were consistently more likely than SSTI isolates to be oxacillin-susceptible.…”

Clinical, economic and societal impact of antibiotic resistance

“…Nosocomial infections overwhelmingly dominate cases where MDR pathogens are implicated, but drug-resistant infections are increasingly becoming common in the community. This has been especially true with the emergence of communityacquired MRSA [3].…”

Decreasing Duration of Antibiotic Prescribing for Uncomplicated Skin and Soft Tissue Infections

“…1 The incidence of SSTIs is increasing, 2 in part due to emergence of methicillin resistant Staphylococcus aureus. 3 Infectious Diseases Society of America guidelines for the management of SSTIs suggest that antibiotic courses of 5 days are effective in cases of nonpurulent cellulitis, with extension of treatment as indicated in cases without notable clinical improvement in that time. 4 Short courses of antibiotics may be beneficial to help prevent development of resistant bacteria, lessen cost, and reduce the abstract BACKGROUND AND OBJECTIVE: Short courses of antibiotics are often indicated for uncomplicated skin and soft tissue infections (uSSTIs).…”