Published Date: 1998-02-25 23:50:00
Subject: PRO> Staphylococcus, drug-resist., community acquired - USA
Archive Number: 19980225.0366

STAPHYLOCOCCUS, DRUG-RESISTANT, COMMUNITY ACQUIRED - USA
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A ProMED-mail post
Date: Wed, 25 Feb 1998 02:02:43 -0500
From: Robert A. LaBudde <ral@lcfltd.com>
Source: ANIMALNET (D. Powell, Univ. Guelph) Feb. 24 /98 (from a press release)

DRUG-RESISTANT INFECTION ONCE FOUND ONLY IN HOSPITALS NOW PRESENT IN
COMMUNITY
Drug-resistant _Staphylococcus aureus_, a predominantly hospital-acquired
infection, has been identified in children outside of the hospital setting
with no identified risk factors, according to a study by researchers at the
University of Chicago Children's Hospital, published in the February 25
issue of the Journal of the American Medical Association.
"This is the first published study to indicate that methicillin-resistant
_Staphylococcus aureus_ (MRSA) infections that are already resistant to many
types of antibiotics are now found in non-chronically ill children outside
of the hospital environment," said Robert S. Daum, M.D., professor of
pediatrics at the University of Chicago and a co-author of the study.
"This suggests a significant change in the way the organism is spread among
the population. We need additional research focused on the mechanisms of
community-acquired infections."
The retrospective study looked at the medical records of children
hospitalized for MRSA at the University of Chicago Children's Hospital. It
compared the cases of children with MRSA from August 1988 to July 1990 with
those seen from August 1993 to July 1995.
After examining the records of children with community-acquired MRSA during
the two time periods, the researchers focused on children with no known
risk factors for infection. Among eight children with "community-acquired"
MRSA, only one case in the first two-year period lacked an identified risk
factor, whereas 25 out of 35 cases in the second two-year period lacked an
identified risk factor.
Risk factors for infection were described as previous hospitalization or
frequent antibiotic use, history of intubation, an underlying chronic
disorder, presence of a catheter, history of any surgical procedure, or
household contact with a person who has identified risk factors.
The researchers also found interesting differences between
hospital-acquired and community-acquired MRSA infections. Although
hospital-acquired MRSA infections appeared to be drug resistant to many
antibiotics, community-acquired MRSA infections were susceptible to drug
other than methicillin. However, the researchers predict this may change
over time.
"This study should make physicians aware that community-acquired MRSA
infections exist, but it should not change their current practice for
treating the infection," said Betsy C. Herold, M.D., assistant professor of
pediatrics at the University of Chicago and lead author of the study.
"First-line antibiotics are still the best therapy for these infections."
The University of Chicago researchers conclude that the results of this
study underscore the need for further investigation. They have already
begun a study to evaluate the transmission of these organisms by
identifying children colonized with _Staphylococcus aureus_ that do not have
symptoms of illness.
Dr. Herold's co-authors include Lilly C. Immergluck, M.D., Melinda C.
Maranan, M.D., Diane S. Lauderdale, Ph.D., Ryan E. Gaskin, Susan
Boyle-Vavra, Ph.D., Cindy D. Leitch, and senior author Robert S. Daum, M.D.

--
Robert A. LaBudde, PhD, PAS, Dpl. ACAFS
Least Cost Formulations, Ltd.
824 Timberlake Drive
Virginia Beach, VA 23464-3239
e-mail: ral@lcfltd.com
......................................es
--
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