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April 28, 2004

Community-Acquired Methicillin-Resistant

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(16):1960-1961. doi:10.1001/jama.291.16.1960

To the Editor: In their study of laboratory isolates, Dr Naimi and colleagues1 found that community-acquired methicillin-resistant Staphylococcus aureus (MRSA) had different clinical, demographic, and microbiological characteristics than health care−associated MRSA. The authors acknowledged that their study was not population-based. Many studies on this topic have not been population-based and the majority have not tried to measure community-associated MRSA prevalence.2 Some have suggested that control of health care–associated MRSA, which Naimi et al found to account for a large majority of MRSA isolates in Minnesota, may be more difficult if MRSA becomes widespread in the community.3 Prevalence studies, preferably population-based, are needed to determine how widespread MRSA is in communities and nations. Available prevalence studies suggest that MRSA is not yet widespread in the United States or Europe.2 In a population-based study of a Native American population, focusing on a significant increase in community MRSA infections in which MRSA was accounting for 34% of community S aureus infections, Leman et al4 found that only 2% of the random sample of the population tested had MRSA colonization.

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