Sludge Watch ==> Community Acquired Resistant Staph Aureus Epidemic - Canada needs

[Maureen Reilly]

Sludgewatch Admin:

In Atlanta and Houston the staph aureus antibiotic resistant strains are 
already more than 70% of cases in the community.


It is worthwhile reading the whole report available free at:
http://www.cmaj.ca/cgi/content/full/176/1/54
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Public Health

Community-associated MRSA: Superbug at our doorstep

Michael Hawkes, Michelle Barton, John Conly, Lindsay Nicolle, Clare Barry 
and Elizabeth L. Ford-Jones
Michael Hawkes, Michelle Barton and Elizabeth Ford-Jones are with the 
Department of Infectious Diseases, The Hospital for Sick Children, Toronto, 
Ont.; John Conly is with the Department of Medicine, University of Calgary, 
Calgary, Alta.; Lindsay Nicolle is with the Department of Infectious 
Diseases, University of Manitoba, Winnipeg, Man.; Clare Barry is with the 
Ministry of Health and Long-Term Care, Toronto, Ont.

Correspondence to: Dr. John Conly, Department of Medicine, University of 
Calgary, Room 930 North Tower, Foothills Medical Centre, 1403 29th St. NW, 
Calgary AB T2N 2T9; fax 403 944-1095; john.conly at calgaryhealthregion.ca

While the potential for a devastating influenza pandemic has captured the 
imagination of the medical community and the population at large, another 
epidemic is currently raging in the United States and has already made 
inroads in Canada.1 Clones of community-associated methicillin-resistant 
Staphylococcus aureus (CA-MRSA) are spreading with alarming rapidity and are 
replacing methicillin-sensitive strains of S. aureus as the most common 
cause of skin and soft-tissue infection. Methicillin resistance among 
community isolates of S. aureus has already exceeded a staggering 70% in 
Houston2 and Atlanta3 and threatens to emerge in force north of the border. 
CA-MRSA is an "old foe with new fangs"4: a pathogen combining virulence, 
resistance and an ability to disseminate at large.5 Most CA-MRSA infections 
involve the skin and soft tissue; however, severe and sometimes fatal 
infections have been observed, including sepsis, necrotizing pneumonia, 
purpura fulminans, pyomyositis and necrotizing fasciitis, even in healthy 
patients. To address this urgent problem, new guidelines for the management 
and prevention of CA-MRSA have been developed.6



At present, the prevalence of CA-MRSA in Canada is unknown except for in 1 
or 2 provinces that are conducting active surveillance for CA-MRSA. Based on 
the collective clinical experience of infectious disease experts across 
Canada, the prevalence is presently thought to be low, but to be rising in 
most sectors of the country. Outbreaks and isolated cases of CA-MRSA have 
been reported in Canada since the 1980s, as shown in Table 1. However, we 
are now concerned about the widespread dissemination and dominance of 
CA-MRSA in Canada, as has been observed in the United States. If Canada is 
to delay or prevent the emergence of CA-MRSA in its communities, vigilance 
and determined control efforts will be needed. Thus, these new guidelines 
for Canadians come at a critical time.

See the whole report:
http://www.cmaj.ca/cgi/content/full/176/1/54