Article Text

  1. N. Tan,
  2. G. Tagudar,
  3. J. Tsui,
  4. J. Perlroth,
  5. A. Shay,
  6. K. Bharadwa,
  7. J. Cronin,
  8. B. Spellberg,
  9. A. S. Bayer,
  10. L. G. Miller
  1. Harbor-UCLA Medical Center and Harbor-UCLA LA Biomedical Sciences Research Institute, Torrance


Background Studies on risk factors for community acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are almost always done retrospectively and are therefore unable to assess important exposures that may have led to MRSA acquisition. Furthermore, there are no prospective studies that have evaluated CA-MRSA risk factors among a largely adult population of patients.

Methods We approached 167 consecutive patients admitted to Harbor-UCLA Medical Center with S. aureus infections between Feb. and Aug. 2004. If the patients agreed, we consented and administered a questionnaire about their exposure, collected information from their medical chart.

Results One hundred fifty seven patients (94%) were consented; 114 (73%) of these patients had CA infections. Among these, 71 (62%) had MRSA and 43 (38%) had methicillin-susceptible S. aureus (MSSA). Most patients (86%) had skin and/or soft tissue infections (SSTIs). Compared to patients with CA-MSSA infection, patients with CA-MRSA infection (p ≤ 0.05) were younger, more likely to have had close contact with someone with an SSTI in the past month, snort illegal drugs, be Caucasian or African American, and be incarcerated in the past year. A multivariate analysis of these risk factors shows only age to be an independent predictor of CA-MRSA infection.

Conclusion Risk factors such as younger age, recent contact with a person with an SSTI, use of illicit nasal drugs and Caucasian or African American ethnic background were strongly suggestive of MRSA infection, although lack of these factors did not rule out MRSA infection. However, in settings where MRSA is endemic, treating infections for MRSA is recommended.

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