1. ©2008, Promega Corporation. All rights reserved. Emerging Pathogens Community-Associated Methicillin- Resistant Staphylococcus aureus

2. 2 Staphylococcus aureus Commonly colonizes the skin, axillae, perineum, nasal passages of mammals ~30% of the population is temporarily or permanently colonized Can be an opportunistic pathogen Quickly develops resistance to  -lactam antibiotics such as penicillin and macrolide antibiotics such as erythromycin. Photo credit: Image #7488 CDC/ Rodney M. Donlan, Ph.D.; Janice Carr Photo courtesy of the CDC Public Health Image Library (PHIL).CDC Public Health Image Library (PHIL).

3. 3 HA-MRSA: Health Care-Associated MRSA Methicillin-Resistant Staphylococcus aureus (MRSA) Appeared in the 1960s First case reported in the UK in 1961 as a nosocomial (hospital acquired) infection Reports from Japan, rest of Europe and Australia First case in the US in 1968 Associated with hospitalization, long-term care, surgeries, dialysis, ventilation, other invasive procedures multidrug resistant

4. 4 CA-MRSA: Community-Associated MRSA First cases in early 80s 1997-1999 four pediatric deaths in Minnesota and North Dakota were attributed to CA-MRSA 2007, a high school athlete died of CA-MRSA infection in Virginia, two other HS students ill 2007, 13 cases in Rockville, MD high school and cases in OH and MI Photo credit: Image #7821 CDC/ Janice Haney Carr/ Jeff Hageman, M.H.S. Photo courtesy of the CDC Public Health Image Library (PHIL).CDC Public Health Image Library (PHIL).

5. 5 CA-MRSA Cases not associated with risk factors of hospitalization, long-term health care, or invasive medical procedures Not as drug resistant as HA-MRSA Often carry gene encoding a skin cytotoxin allowing it to be invasive Populations at risk: people living in close quarters like dormitories, military barracks, prisons; people participating in contact sports; injection drug users Not a new bacterial species: common sense measures and good hygiene are best practices to prevent spread and serious infection A video and other course materials on prevention of MRSA infection in athletic settings are available from the CDC.video and other course materials

6. 6 References CDC Four Pediatric Deaths from Community-Acquired Methicillin Resistant Staphylococcus aureus in Minnesota and North Dakota, 1997- 1999. MMWR Weekly (1999) 48, 707-10. Naimi, T. et al. (2003) Comparison of Community- and Health Care- Associated Methicillin-Resistant Staphylococcus aureus Infection. J. Amer. Med. Assoc. 290, 2976–84. Athletes Susceptible to Antibiotic-resistant Staph Infections. Science Daily. http://www.sciencedaily.com/releases/2008/06/080624151110.htmhttp://www.sciencedaily.com/releases/2008/06/080624151110.htm Borlaug, G., Davis, J.P., Fox, B.C. (2005) Community Associated Methicillin Resistant Staphylococcus aureus (CA MRSA): Guidelines for Clinical Management and Control of Transmission. Wisconsin Division of Public Health Klevens, R.M. et al. (2007) Invasive Methicillin-Resistant Staphylococcus aureus Infections in the United States. J. Amer. Med. Assoc. 208, 1763– 71.