Community Acquired MRSA

Potential for even greater disaster?

Much of focus is on Hospital Acquired MRSA but not all cases of MRSA arise in hospitals. Community acquired MRSA is more prevalent among children and young adults. It is rare in the UK (only about 100 cases have been identified in the last three years) but more prevalent in the USA, mainland Europe and Australia.

The strains involved are resistant to fewer antibiotics than hospital MRSA, but produce a dangerous toxin (called PVL ) that can lead to skin infections such as large boils or clusters of boils (up to 10 cm in diameter in some cases) and deep-seated abscesses. If the bacteria get into the lungs, fortunately a rare event, a devastating pneumonia that kills more than 40 per cent of patients can result.

It has been found that community acquired strains are very different from hospital strains but If the evolution of MRSA continues apace, the concepts of hospital and community MRSA strains may become blurred. Community strains could become more like the hospital strains in terms of antibiotic resistance and become harder to treat. Or hospital strains could become more dangerous if they acquire toxin genes , and could cause serious disease in younger, healthier people. You might not need catheters and the close confines of an intensive care unit to get MRSA in hospital. These would be truly frightening developments.

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Reference:

Much of the above information was derived from a paper by Dr Mark Enright of the Department of Infectious Disease Epidemiology, Imperial College London.