TORRANCE, Calif. (February 6, 2007) - In a continuing effort to improve the clinical management of community-acquired methicillin-resistant staphylococcus aureas (CA-MRSA), Loren Miller, M.D., M.P.H. and colleagues at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed) found no reliable epidemiological or clinical risk factors that could distinguish patients with CA-MRSA infection from patients with CA-MSSA infection. They suggest that, in settings where CA-MRSA is common, all patients with suspected CA S. aureus infection be placed in contact isolation and given appropriate therapy until the pathogens are identified. "What this means", says Dr. Miller, "is that the average Joe or Jane can get CA-MRSA. A person doesn't have to be special to get CA-MRSA. So a physician who thinks their patient with a skin infection is unlikely to have CA-MRSA because they haven't been to jail or use illicit drugs is apt to be wrong over half of the time." The research findings appear in the February 15, 2007 edition of Clinical Infectious Diseases.
In a separate article published in the same journal, Miller ands his colleagues investigated the outcomes for patients with either CA-MRSA or CA-MSSA skin infection 30 and 120 days after diagnosis. Despite the common belief that patients with CA-MRSA skin infection have more-serious outcomes than do patients with CA-MSSA infection, the authors found similar outcomes in the two groups. However, CA-MRSA infections are widely believed to be more transmissible than CA-MSSA infection. The authors also found data that close contacts of persons with CA-MRSA infection may have a higher likelihood of acquiring an infection than those with CA-MSSA. This observation supports the notion that CA-MRSA strains are more highly transmissible than the "old-fashioned" S. aureus, or CA-MSSA, strains.
CA-MRSA is a methicillin-resistant Staphylococcus aureus infection, first recognized in the 1980s. Traditionally MRSA infections have been associated with hospitalization or other healthcare-associated risk factors, but in recent years, physicians and other healthcare providers have observed an increasing number of people with MRSA infections who lack traditional healthcare-associated risk factors. These people appear to have community-associated infections. Most infections caused by Staphylococcus aureus are skin and soft tissue infections such as abscesses or cellulitis. CA-MRSA is the most common cause of skin infection in many locales in the U.S., including Southern California. CA-MRSA strains are notable for their ability to spread in closed settings and cause recurrent infections among healthy persons.
These findings continue a series of investigations and research into CA-MRSA with data from the Los Angeles area. In findings published in February 2005 in The New England Journal of Medicine, Dr. Miller reviewed records of more than 800 patients whose wound cultures grew MRSA in the Los Angeles area from January 2003 to April 2004. 14 people were identified with necrotizing fasciitis, informally known as "flesh-eating bacteria," over a 14-month stretch through April 2004. As a result, physicians have been instructed that if they see cases of necrotizing fasciitis, they are to treat for the resistant bug in addition to the other known causes until they know the causative bacterial.
Dr. Miller and his colleagues in LA BioMed's Division of Infectious Disease have a reputation for examining cutting-edge issues. For example:
The Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed) is one of the largest independent, not-for-profit biomedical research institutes in Los Angeles County. Affiliated with both the David Geffen School of Medicine at UCLA and the Harbor-UCLA Medical Center, the Institute has an annual budget of over $73 million and currently supports more than 1,000 research studies in areas such as cardiology, emerging infections, cancer, women's health, reproductive health, vaccine research, respiratory physiology, neonatology, molecular biology, dermatology and genetics. LA BioMed also plays a pivotal role in the training of young physician - scientists and scientists-to-be and is active in promoting the health and well being of nearby communities through community service programs that meet a variety of social and medical needs.
Clinical Infectious Diseases