How to prevent transmission of MRSA in the open community?

Demographic characteristics of hospital-acquired (HA) MRSA infections differ from those of CA-MRSA, the former occurring mainly in elderly people and the latter occurring in young people. HA-MRSA infections are particularly associated with surgical wounds or intravenous indwelling catheters. CA-MRSA infections are mainly skin and soft tissue infections occurring in patients with no initial skin wounds. The Panton-Valentine leukocidin (PVL) produced by CA-MRSA strains represents, with its necrotic activity, one of the virulence factors possibly associated with cutaneous tissue destruction. These PVL-positive CA-MRSA are easily transmissible not only within families but also on a larger scale in community settings such as prisons, schools and sport teams. Skin-to-skin contact and indirect contact with contaminated towels, sheets, and sport equipment seem to represent the mode of transmission. The exact prevalence of CA-MRSA is still unknown. Isolates collected at hospitals certainly represent the tip of the iceberg. CA-MRSA strains have been detected in France, Switzerland, Germany, Greece, the Nordic countries, Australasia, Netherlands and Latvia. Where cases of skin and soft tissue infections have been observed in a close-living community of patients, therapeutic and infection control measures have proven successful in controlling the outbreak. The main question is how to prevent transmission of these strains in the open community. Journal of Eurosurveillance 2004; 9: 5.