4.5 Article

Community-associated methicillin-resistant Staphylococcus aureus infections at an Army training installation

Journal

EPIDEMIOLOGY AND INFECTION
Volume 138, Issue 5, Pages 721-729

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0950268810000142

Keywords

Antibiotic resistance; antimicrobial drugs; community outbreaks; methicillin-resistant Staphylococcus aureus (MRSA)

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To assess the burden of community-associated methicillin-resistant Staphylococcus aureus (CA-M RSA) in a high-risk population, the monthly incidence of laboratory-confirmed M RSA in service members/trainees stationed at Fort Benning, Georgia, USA without hospitalization or surgery documented 30 days prior to infection was calculated for calendar years 2002-2007. Clinical management and antibiotic susceptibility patterns were also evaluated. By 2007, 67% of S. aureus strains were M RSA, and 82% of these were community-associated, primarily in trainees. In total, 3531 CA-MRSA infections were identified. Rates appeared to be seasonal, peaking at 42 cases/1000 soldiers in 2005, with rates remaining above 35/1000 soldiers thereafter. Increased prescription of effective antibiotics was documented. Susceptibility to clindamycin, ciprofloxacin, and levofloxacin decreased from 2002 to 2007 by 6%, 17%, and 14%, respectively. The sustained high prevalence of CA-M RSA observed highlights the need for more vigilant population-based counter-measures at military training installations.

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