Staphylococcus Research Today is a free monthly online journal that collates and summarizes the latest research about Staphylococcus, including details on mrsa, hospitals, infection, antibiotic resistance, superbugs.

Emergence of community-associated methicillin resistant Staphylococcus aureus in Hawaii, 2001-2003.

Estivariz CF, Park SY, Hageman JC, Dvorin J, Melish MM, Arpon R, Coon P, Slavish S, Kim M, McDougal LK, Jensen B, McAllister S, Lonsway D, Killgore G, Effler PE, Jernigan DB

Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, US Department of Health and Human Services, Atlanta, GA 30333, USA. cge3@cdc.gov <cge3@cdc.gov>

OBJECTIVES: We conducted a retrospective study to determine trends and characteristics of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in Hawaii. METHODS: We reviewed medical records of patients with MRSA infections during July 2001-June 2003 in four healthcare facilities. A case was defined as a patient with MRSA infection (colonization excluded), diagnosed in ambulatory settings or < or = 48 h after hospitalization, without previous MRSA or healthcare risk factors. Pulsed-field gel electrophoresis (PFGE) and typing of resistance and toxin genes was performed in 40 MRSA isolates. RESULTS: CA-MRSA infections increased from 28 (23% of MRSA infections) to 65 (32%) per quarter over the 2-year period (P<0.05). Pacific islanders accounted for 51% of 389 case-patients, but only 24% of the Hawaii population. In the pediatric hospital, Pacific Islanders represented 76% of 90 case-patients versus 35% of the hospital population. Hospital admission, required for 40% (154/389), was associated with prior antimicrobial treatment (P<0.01). The staphylococcal cassette chromosome mec type IV was detected in 38/40 isolates; 31 isolates carried Panton-Valentine leukocidin genes and 22 belonged to the same staphylococcal lineage. CONCLUSIONS: In Hawaii, prevention strategies for CA-MRSA infections should focus on Pacific Islanders. CA-MRSA infections in Hawaii appear to be related to strains causing disease throughout the United States.

Published 19 March 2007 in J Infect, 54(4): 349-57.
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