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Journal Review

Journal Review

Kallen AJ, Driscoll TJ, Thornton S, et al. Increase in community-acquired methicillin-resistant Staphylococcus aureus at a naval medical center. Infect Control Hosp Epidemiol 2000; 21:223-226.

Adding further evidence to other reports that methicillin-resistant Staphylococcus aureus (MRSA) has become a community-acquired pathogen, the authors traced an increase of MRSA at a San Diego medical center from 1994 through 1997.

MRSA isolates were considered community-acquired if the patient had no hospitalizations within the preceding six months and if the organism had been obtained from an outpatient culture or was isolated within 24 hours of hospital admission. The records of patients with community-acquired MRSA were screened for possible MRSA risk factors. Risk factors included a history of antibiotic use within three months; a history of intravenous drug use; admission to a nursing home or rehabilitation hospital within six months; a household contact with MRSA; the presence of an intravenous or urinary catheter; or the diagnosis of malignancy or chronic liver, lung, renal, or vascular disease.

There were 43 MRSA isolates from 1994 to 1995 and 91 isolates from 1996 to 1997. Thirteen MRSA isolates (30%) were community-acquired from 1994 to 1995 and 45 (49%) from 1996 to 1997. When patients were evaluated for risk factors for MRSA colonization or infection, 6 (14%) of 43 patients from 1994 to 1995 and 26 (29%) of 91 patients from 1996 to 1997 lacked identifiable risk factors.