Infections due to community-acquired methicillin-resistant Staphylococcus aureus: an emergent epidemic in Kentucky

In recent years, epidemics of Methicillin-Resistant Staphylococcus aureus (MRSA) infections in patients not associated with the health care system have been reported in several states. This community-acquired MRSA (CA-MRSA) is microbiologically distinct from hospital-acquired MRSA (HA-MRSA) and has a predilection to cause severe skin and soft tissue infections and a particularly virulent necrotizing pneumonia. Many patients have suffered serious morbidity and mortality because of thefailure to recognize CA-MRSA as the pathogen in these infections. There are also serious infection control implications associated with these epidemics. Here we report 15 cases of CA-MRSA infections managed by the Infectious Diseases Division at the University of Louisville and offer guidelines for diagnosis, treatment, and infection control based on our experience. Primary care and emergency physicians as well as infection control professionals need to be aware that there is an emerging epidemic of CA-MRSA infections in the state of Kentucky. Several of our current practices regarding treatment and isolation will need to be modified to prevent the morbidity and possibly mortality associated with some CA-MRSA infections.