MRSA in the Community… Where is it coming from?

MRSA was once only found in patients in the healthcare setting. Over the last 20 years, it has shown up in the community. People are getting MRSA with no exposure to a healthcare system. As the number of overall MRSA cases increased, so did the prevalence of community acquired MRSA cases without an identifiable risk.
According to The New England Journal of Medicine, MRSA is the most common cause of skin infections being seen in emergency rooms in the US. Vance Garrison Fowler MD, a professor of medicine at Duke University, said there has been an explosion of mostly soft tissue infections among community dwelling healthy individuals with no prior healthcare contact. Fowler also said the virtual explosion of MRSA soft tissue infections came from nowhere.
Beginning in the mid-2000s, infections have gradually declined both inside and outside the hospital setting. It is a mystery where the genetically distinct clones came from and don’t know where they went. According to a study published in JAMA, there were an estimated 30,800 fewer invasive MRSA infections reported in the US in 2011 compared to 2005. MRSA rates decreased by 3.6% in 2015. Then again by another 1.4% in 2016.
Horizonal infection control strategies that are not pathogen specific but are bundles of interventions have led to the reductions. Examples include hand hygiene, environmental cleaning and contact precautions. These interventions have led to reductions in acquisition and infections due to multidrug-resistant organisms. Unfortunately, the decrease in MRSA is less significant in the community setting.  #MRSAless

Reference: MRSA over 3 decades: A pathogen with devastating complications; Infectious Disease News, August 2017