Background:

A recent publication reported the detection of a multidrug-resistant strain of MRSA among men who have sex with men (MSM) in Boston and San Francisco . The strain is derived from a common clone (USA 300 PFGE type) causing community-acquired infections in the  US that acquired additional genetic resistance factors (including resistance to tetracycline, clindamycin and mupirocin).  A large proportion of the infections involved the buttocks, genitals, or perineum.  The study did not establish whether the infections were sexually transmitted or not.

Multi-drug resistant USA 300 is still rare in the US , and local laboratory based surveillance data do not show this pattern of resistance locally.  Healthcare providers should remain vigilant for community-acquired MRSA infections when evaluating and treating patents with skin and soft tissue infections and obtain culture and sensitivity testing whenever possible to guide therapy and help identify changes in local resistance patterns. 

Complete recommendations for evaluation and management of MRSA SSTI are available on the public Health website.

References

Emergence of Multidrug-Resistant, Community-Associated, Methicillin-Resistant Staphylococcus aureus Clone USA300 in Men Who Have Sex with Men. Diep, et al. Ann Intern Med 17 January 2008.

Editorial: More Challenges in the Prevention and Management of Community-Associated,Methicillin-Resistant Staphylococcus aureus Skin Disease. Gorwitz, et al. Ann Intern Med 17 January 2008.