How to handle a CA-MRSA outbreak.

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) continues to make headlines because of large outbreaks in daycare centers and among members of athletic teams. CA-MRSA infections in children commonly lead to hospitalization. Life-threatening infections, such as necrotizing pneumonitis and brain abscess, can occur. The organism has crossed into hospitals and is now a common cause of hospital-acquired sepsis. Multidrug-resistant strains of MRSA are emerging in Asia, with the resistance based on either a novel gene cassette or a transmissible plasmid. The routine use of antibiotics in livestock seems to be contributing to the emergence of resistant organisms, and some of these have already produced human infection. Fortunately, most cutaneous CA-MRSA infections present as abscesses or furunculosis, and these manifestations generally respond to drainage. The recurrence and attack rates of close contacts are high and relate to persistent colonization.