County of Los Angeles
Department of Public Health
Acute Communicable Disease Control
313 N. Figueroa Street, Room 212
Los Angeles, CA 90012
Phone: (213) 240-7941
Fax: (213) 482-4856
E-Mail:acdc2@ph.lacounty.gov

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"Staph" or Community-Associated Methicillin-Resistant Staphylococcus aureus (CAMRSA) Information





Basic Facts and Background

Staphylococcus aureus, commonly referred to as “Staph,” are bacteria found in the nose or skin. Staph are the most common cause of skin infections. Some Staph have developed resistance to the most common family of antibiotics that treat skin and blood infections. These Staph are called methicillin (antibiotic)-resistant Staphylococcus aureus (MRSA). MRSA infections are common in hospitals and other healthcare settings, like dialysis centers or nursing homes. MRSA infections in hospitals often affect the very old and the very young or the very sick. However, recently MRSA infections have been found in healthy people outside of the hospital. Most of these MRSA infections are found in the skin and soft-tissue (muscle, fascia, fat). Since they occur in people in the community, they are referred to as community-associated MRSA (or CAMRSA) infections.

CAMRSA is clinically and genetically different from MRSA infections that people acquire in healthcare settings. The information below should help consumers and healthcare professionals understand CAMRSA as a new and emerging disease.

Information for Consumers

• MRSA: A (Sometimes) Deadly Scourge (New York Times, October 2007)
• Community-Associated MRSA Information for the Public
• MRSA Podcast by the CDC (CDC, October 2007)
• Questions and Answers about MRSA in Schools (CDC, October 2007)
• Living with MRSA: Learning how to control the spread of Methicillin-Resistant Staphylococcus Aureus (MRSA) (March 2006)

• Personal Hygiene and Methicillin-resistant Staphylococcus aureus Infection
  (EID, March 2006)

• QUESTIONS & ANSWERS: STAPH/MRSA SKIN INFECTIONS (Jan. 14, 2004) Educational handout on CAMRSA for patients and their families.

• PREGUNTAS Y RESPUESTAS: Infecciones de la Piel por Estafilococo Aureus Resistentes a los Antibióticos (Mar. 15, 2004)

• Issues in Healthcare Settings: Antimicrobial Resistance: Community-Associated MRSA Frequently Asked Questions
  (CDC, Division of Healthcare Quality Promotion [DHQP]) Overview of CAMRSA for patients as well as healthcare professionals with references for further study.

• Fact Sheet for Patients: Antibiotic-Resistant "Staph" Skin Infections
  (Mar.2003) Questions and answers for patients concerned about Staph.

• This is MRSA (Methicillin-Resistant Staphylococcus Aureus
  (Color-enhanced version, Mar. 15, 2004) VIEWER DISCRETION ADVISED: This web page contains digital photographs of skin infections and wounds caused by community-associated methicillin resistant Staphylococcus aureus (MRSA/Staph).

Information for Clinicians

• Community-Associated MRSA Information for Clinicians
• FACT SHEET FOR HEALTH CARE PROVIDER: Community-Associated Methicillin-Resistant Staphylococcus aureus Skin Infections (Mar. 20, 2003) Definition, clinical presentation, diagnosis, treatment, prevention, and surveillance of CAMRSA for health care providers.

• Guidelines For Evaluation & Management of Community-Associated Methicillin-Resistant Staphylococcus aureus Skin & Soft Tissue Infections in Outpatient Settings (Sep. 2, 2004) Interim clinical guidelines for healthcare providers to manage SSTI in outpatients in settings of increasing levels of CAMRSA

• Community-Associated Methicillin Resistant Staphylococcus Aureus: Overview of CAMRSA by the CDC

• Community Associated Methicillin-Resistant Staphylococcus Aureus: an Emerging Infectious Disease in Los Angeles County (The Public's Health, July/Aug 2005)* Provides short summary of disease burden and includes clinical, epidemiological and laboratory hallmarks. Recommendations provided regarding treatment, decolonization, education, infection control and notification.

• Community-Associated (CA) Methicillin-Resistant Staphylococcus aureus - An overview of outbreaks affecting specific populations (Clinical Infectious Diseases, Aug 2005)

• Public Health Grand Rounds: CAMRSA Archived webcast that examines the case of Seattle-King County, Washington, a metropolitan community, whose public health department is building partnerships, providing education, and making surveillance a top priority to prevent the spread of antimicrobial resistance. Includes resources on preventing MRSA in athletic settings.

• This is MRSA (Methicillin-Resistant Staphylococcus Aureus (Color-enhanced version, Mar. 15, 2004) VIEWER DISCRETION ADVISED: This web page contains digital photographs of skin infections and wounds caused by community-associated methicillin resistant Staphylococcus aureus (MRSA/Staph).

• Editorial: How to prevent transmission of MRSA in the open community? (Eurosurveillance, Nov. 2004) Differences and characteristics of hospital-acquired MRSA and community-associated MRSA.

• Severe Community-acquired Pneumonia Due to Staphylococcus aureus, 2003–04 Influenza Season (EID, June 2006)

• Public Health Dispatch: Outbreaks of Community-Associated Methicillin-Resistant Staphylococcus aureus Skin Infections - Los Angeles County, California, 2002-2003 (MMWR Weekly, Feb. 7, 2003; also in The Public’s Health, Feb. 2003*) This report describes investigations of CA-MRSA in Los Angeles County

• Spider-bite Myths & Misdiagnosis of CA-MRSA by Pediatricians in L.A. County
  (The Public’s Health, Sep. 2003)* Immediate, accurate, and effective diagnosis and treatment is essential to limit the spread of CA-MRSA skin infections among children and their families.

• Community-Associated MRSA in Hospitalized Children: Results From an Interim Analysis (The Public’s Health, Sep. 2003)* Immediate, accurate, and effective diagnosis and treatment is essential to limit the spread of CA-MRSA skin infections among children and their families.

• Pediatric MRSA Interim Reporting (The Public’s Health, May 2003)* Background explanation of six-month reporting requirement.

• Heterosexual Transmission of Community-Associated MRSA Documented (Reuters Health Information, February 2007) Clinicians in New York have identified three households in which there was clinical, microbiological, and molecular epidemiological evidence of heterosexual transmission of community-associated methicillin-resistant staphylococcus aureus (CA-MRSA).

• Postpartum Mastitis and Community-acquired Methicillin-resistant Staphylococcus aureus (Emerging Infectious Diseases, February 2007) Reports of methicillin-resistant S. aureus (MRSA) PPM among young, healthy women lacking traditional risk factors for MRSA have emerged in the past few years.

• Pro-MED Resources: on Methicillin-Resistant Staphylococcus Aureus, for physicians. After clicking "Search Archives" in the left column, type in MRSA as a search word and then hit "search" for a list of recent news articles from around the world about MRSA.

Medscape Articles *

* A subscription is required to view Medscape articles. Some identifying information will need to be provided. Subscriptions to Medscape are free at this time.

• Evaluating Strategies to Improve Patient Outcomes: Hospital-Associated and Community-Acquired MRSA (Medscape, December 2006) Explore the epidemiology of methicillin-resistant Staphylococcus aureus infection; review new guidelines and current treatment options. (Medscape, December 2006) Explore the epidemiology of methicillin-resistant Staphylococcus aureus infection; review new guidelines and current treatment options.
• In Touch With the Experts™: Community-Acquired and Healthcare-Associated MRSA: Improving Patient Outcomes (Medscape, December 2006) Recognize the threats of various methicillin-resistant Staphylococcus aureus (MRSA) infections, learn the difference between the 2 types of infection, and review the efficacy data for the anti-MRSA agents.
• Questions About MRSA and Answers From the Experts (Medscape, November 2006) Clinicians are concerned about (MDROs) multidrug-resistant organisms, and are seeking answers to many practical, clinical questions ranging from the best way to identify patients with MRSA to what healthcare professionals should do if they have personally had an MRSA infection.
• Community-Acquired MRSA Skin/Soft Tissue Infection Rates Increasing (Medscape Medical News, March 2006) should be considered in the differential diagnosis of patients presenting with skin and soft tissue infections.
• Infectious Diseases Expert Reviews and Commentary Antibiotic Resistance: (Medscape, March 2006) This is a report from the Toronto Invasive Bacterial Disease Network, a prospective cohort study of patients with invasive pneumococcal infections.
• Evaluating Strategies to Improve Patient Outcomes: Community-Acquired and Nosocomial MRSA (Medscape, February 2006)
• Community-Acquired MRSA: Evolving Pathogens (Medscape, May 2005) an update on methicillin-resistant Staphylococcus aureus (MRSA), particularly community-acquired MRSA (CA-MRSA), a brief update on immunizations, and an extensive review of research on the obesity epidemic in the United States and the metabolic syndrome.
• Antibiotic Selection for Infections Involving Methicillin-Resistant Staphylococcus aureus (Medscape.com), Dec. 20, 2004) This Certified Medical Education (CME) activity is made available to physicians, pharmacists, and registered nurses on the Medscape site as a service to their audience.

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