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Emerging Pathogens

Emerging Pathogens. Community-Associated Methicillin-Resistant Staphylococcus aureus. Staphylococcus aureus. Commonly colonizes the skin, axillae, perineum, nasal passages of mammals ~30% of the population is temporarily or permanently colonized Can be an opportunistic pathogen

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Emerging Pathogens

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  1. Emerging Pathogens Community-Associated Methicillin-Resistant Staphylococcus aureus

  2. Staphylococcus aureus • Commonly colonizes the skin, axillae, perineum, nasal passages of mammals • ~30% of the population is temporarily or permanently colonized • Can be an opportunistic pathogen • Quickly develops resistance to b-lactam antibiotics such as penicillin and macrolide antibiotics such as erythromycin. Photo credit: Image #7488 CDC/ Rodney M. Donlan, Ph.D.; Janice Carr Photo courtesy of the CDC Public Health Image Library (PHIL).

  3. HA-MRSA: Health Care-Associated MRSA • Methicillin-Resistant Staphylococcus aureus (MRSA) • Appeared in the 1960s • First case reported in the UK in 1961 as a nosocomial (hospital acquired) infection • Reports from Japan, rest of Europe and Australia • First case in the US in 1968 • Associated with hospitalization, long-term care, surgeries, dialysis, ventilation, other invasive procedures • multidrug resistant

  4. CA-MRSA: Community-Associated MRSA • First cases in early 80s • 1997-1999 four pediatric deaths in Minnesota and North Dakota were attributed to CA-MRSA • 2007, a high school athlete died of CA-MRSA infection in Virginia, two other HS students ill • 2007, 13 cases in Rockville, MD high school and cases in OH and MI Photo credit: Image #7821 CDC/ Janice Haney Carr/ Jeff Hageman, M.H.S. Photo courtesy of the CDC Public Health Image Library (PHIL).

  5. CA-MRSA • Cases not associated with risk factors of hospitalization, long-term health care, or invasive medical procedures • Not as drug resistant as HA-MRSA • Often carry gene encoding a skin cytotoxin allowing it to be invasive • Populations at risk: people living in close quarters like dormitories, military barracks, prisons; people participating in contact sports; injection drug users • Not a new bacterial species: common sense measures and good hygiene are best practices to prevent spread and serious infection • A video and other course materials on prevention of MRSA infection in athletic settings are available from the CDC.

  6. References • CDC Four Pediatric Deaths from Community-Acquired Methicillin Resistant Staphylococcus aureus in Minnesota and North Dakota, 1997-1999. MMWR Weekly (1999) 48, 707-10. • Naimi, T. et al. (2003) Comparison of Community- and Health Care-Associated Methicillin-Resistant Staphylococcus aureus Infection. J. Amer. Med. Assoc. 290, 2976–84. • Athletes Susceptible to Antibiotic-resistant Staph Infections. Science Daily. http://www.sciencedaily.com/releases/2008/06/080624151110.htm • Borlaug, G., Davis, J.P., Fox, B.C. (2005) Community Associated Methicillin Resistant Staphylococcus aureus (CA MRSA): Guidelines for Clinical Management and Control of Transmission. Wisconsin Division of Public Health • Klevens, R.M. et al. (2007) Invasive Methicillin-Resistant Staphylococcus aureus Infections in the United States. J. Amer. Med. Assoc.208, 1763–71.

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