Re: MRSA from the Center for Disease control and prevention...

[Guest guest]

See?Its the " Who gets MRSA " part that scares the dickens out of

me.And if any of you have been to Florida, its great for the

sunshine, and no offense to anyone intended, but the pay STINKS and

so does the MEDICAL CARE!!Unfortunately this is where my whole

family relocated to (thanks, MOM) so here we are.

Patty

> MRSA - Methicillin Resistant Staphylococcus aureus

> Fact Sheet

>

>

>

>

>

>

>

> The Centers for Disease Control and Prevention (CDC) has received

> inquiries about infections with antibiotic-resistant

Staphylococcus

> aureus (including methicillin-resistant S. aureus [MRSA]) among

> persons who have no apparent contact with the healthcare system.

This

> fact sheet addresses some of the most frequently asked questions.

>

> What is Staphylococcus aureus?

>

> Staphylococcus aureus, often referred to simply as " staph, " are

> bacteria commonly carried on the skin or in the nose of healthy

> people. Occasionally, staph can cause an infection; staph bacteria

> are one of the most common causes of skin infections in the United

> States. Most of these infections are minor (such as pimples and

> boils) and most can be treated without antibiotics (also known as

> antimicrobials or antibacterials). However, staph bacteria can

also

> cause serious infections (such as surgical wound infections and

> pneumonia). In the past, most serious staph bacteria infections

were

> treated with a certain type of antibiotic related to penicillin.

Over

> the past 50 years, treatment of these infections has become more

> difficult because staph bacteria have become resistant to various

> antibiotics, including the commonly used penicillin-related

> antibiotics (1). These resistant bacteria are called methicillin-

> resistant Staphylococcus aureus, or MRSA.

>

> Where are staph and MRSA found?

>

> Staph bacteria and MRSA can be found on the skin and in the nose

of

> some people without causing illness. Top

>

> What is the difference between colonization and infection?

>

> Colonization occurs when the staph bacteria are present on or in

the

> body without causing illness. Approximately 25 to 30% of the

> population is colonized in the nose with staph bacteria at a given

> time (2).

> Infection occurs when the staph bacteria cause disease in the

person.

> People also may be colonized or infected with MRSA, the staph

> bacteria that are resistant to many antibiotics. Top

>

> Who gets MRSA?

>

> Staph bacteria can cause different kinds of illness, including

skin

> infections, bone infections, pneumonia, severe life-threatening

> bloodstream infections, and others. Since MRSA is a staph

bacterium,

> it can cause the same kinds of infection as staph in general;

> however, MRSA occurs more commonly among persons in hospitals and

> healthcare facilities.

> MRSA infection usually develops in hospitalized patients who are

> elderly or very sick or who have an open wound (such as a bedsore)

or

> a tube going into their body (such as a urinary catheter or

> intravenous [iV] catheter). MRSA infections acquired in hospitals

and

> healthcare settings can be severe. In addition, certain factors

can

> put some patients at higher risk for MRSA including prolonged

> hospital stay, receiving broad-spectrum antibiotics, being

> hospitalized in an intensive care or burn unit, spending time

close

> to other patients with MRSA, having recent surgery, or carrying

MRSA

> in the nose without developing illness (3-6).

>

> MRSA causes illness in persons outside of hospitals and healthcare

> facilities as well. Cases of MRSA diseases in the community have

been

> associated with recent antibiotic use, sharing contaminated items,

> having active skin diseases, and living in crowded settings.

Clusters

> of skin infections caused by MRSA have been described among

injecting

> drug-users (7,8), aboriginals in Canada (9), New Zealand (10) or

> Australia (11,12), Native Americans in the United States (13),

> incarcerated persons (14), players of close-contact sports (15,16)

> and other populations (17-23). Community-associated MRSA

infections

> are typically skin infections, but also can cause severe illness

as

> in the cases of four children who died from community-associated

MRSA

> (24). Most of the transmission in these settings appeared to be

from

> people with active MRSA skin infections. Top

>

> How common is staph and MRSA?

>

> Staph bacteria are one of the most common causes of skin infection

in

> the United States, and are a common cause of pneumonia and

> bloodstream infections. Staph and MRSA infections are not

routinely

> reported to public health authorities, so a precise number is not

> known. According to some estimates, as many as 100,000 persons are

> hospitalized each year with MRSA infections, although only a small

> proportion of these persons have disease onset occurring in the

> community. Approximately 25 to 30% of the population is colonized

in

> the nose with staph bacteria at a given time (2). The numbers who

are

> colonized with MRSA at any one time is not known. CDC is currently

> collaborating with state and local health departments to improve

> surveillance for MRSA. Active, population-based surveillance in

> selected regions of the United States is ongoing and will help

> characterize the scope and risk factors for MRSA in the community.

Top

>

> Are staph and MRSA infections treatable?

>

> Yes. Most staph bacteria and MRSA are susceptible to several

> antibiotics. Furthermore, most staph skin infections can be

treated

> without antibiotics by draining the sore. However, if antibiotics

are

> prescribed, patients should complete the full course and call

their

> doctors if the infection does not get better. Patients who are

only

> colonized with staph bacteria or MRSA usually do not need

treatment.

> Top

>

> How are staph and MRSA spread?

>

> Staph bacteria and MRSA can spread among people having close

contact

> with infected people. MRSA is almost always spread by direct

physical

> contact, and not through the air. Spread may also occur through

> indirect contact by touching objects (i.e., towels, sheets, wound

> dressings, clothes, workout areas, sports equipment) contaminated

by

> the infected skin of a person with MRSA or staph bacteria. Top

>

> How can I prevent staph or MRSA infections?

>

> Practice good hygiene

>

> 1. Keep your hands clean by washing thoroughly with soap and water

>

> 2. Keep cuts and abrasions clean and covered with a proper

dressing

> (e.g., bandage) until healed

>

> 3. Avoid contact with other people's wounds or material

contaminated

> from wounds.

>

> What should I do if I think I have a Staph or MRSA infection?

>

> See your healthcare provider.

>

> What is CDC doing to address MRSA in the community?

>

> CDC is concerned about MRSA in communities and is working with

> multiple partners on prevention strategies.

>

> CDC is working with 4 states in a project to define the spectrum

of

> disease, determine populations affected, and developing studies to

> define who is at particular risk for infection

> CDC is working with state health departments to assist in the

> development of surveillance systems for tracking MRSA in the

> community

> CDC is using the National Health and Nutritional Evaluation Survey

> (NHANES) to estimate the number of individuals in the United

States

> who carry staph bacteria in their nose

> CDC works with laboratories across the country to improve the

> detection of MRSA through training personnel and use of

appropriate

> testing methods

> CDC provides technical expertise to hospitals and state and local

> health departments on infection control in healthcare settings,

> including control of MRSA

> CDC laboratories are working to characterize the unique features

of

> MRSA strains from the community.

> Top

>

>

> References:

> 1. Lowry FD. Staphylococcus aureus infections. New England Journal

of

> Medicine. 1998;339:520-32.

> 2. Kluytmans J, Van Belkum A, Verbrugh H. Nasal carriage of

> Staphylococcus aureus: epidemiology, underlying mechanisms, and

> associated risks. Clin Microbiol Rev. 1997;10:505-20.

> 3. Boyce JM. Methicillin-resistant Staphylococcus aureus.

Detection,

> epidemiology, and control measures. Infect Dis Clinics of North

Am.

> 1989;3:901-13.

> 4. Herwaldt LA. Control of methicillin-resistant Staphylococcus

> aureus in the hospital setting. Am J Medicine. 1999;106:11S-18S;

> discussion 48S-52S.

> 5. Asensio A, Guerrero A, Quereda C, Lizan M, ez-Ferrer M.

> Colonization and infection with methicillin-resistant

Staphylococcus

> aureus: associated factors and eradication. Infec Control Hosp

> Epidemiol. 1996;17:20-8.

> 6. Mulligan ME, Murray-Leisure KA, Ribner BD, et al. Methicillin-

> resistant Staphylococcus aureus: a consensus review of the

> microbiology, pathogenesis, and epidemiology with implications for

> prevention and management. Am J Medicine. 1993;94:313-28.

> 7. Saravolatz LD, Markowitz N, Arking L, Pohloh D, Fisher E.

> Methicillin-resistant Staphylococcus aureus. Epidemiologic

> oberservations during a community-acquired outbreak. ls of

> Internal Medicine. 1982;96:11-16.

> 8. CDC. Community-acquired methicillin-resistant Staphylococcus

> aureus infections—Michigan. MMWR. 1981;30:185-7.

> 9. Embil J, Ramotar K, Romance L, et al. Methicillin-resistant

> Staphylococcus aureus in tertiary care institutions on the

Canadian

> prairies 1990-1992. Infection Control and Hospital Epidemiology

1994;

> 15:646-51.

> 10. Rings T, Findlay R, Lang S. Ethnicity and methicillin-

resistant

> S. aureus in South Auckland. New Zealand Medical Journal 1998;

> 111:151.

> 11. Maguire GP, Arthur AD, Boustead PJ, Dwyer B, Currie BJ.

Emerging

> epidemic of community-acquired methicillin-resistant

Staphylococcus

> aureus infection in the Northern Territory. Medical Journal of

> Australia 1996; 1996; 164:721-3.

> 12. Collignon P, Gosbell I, Vickery A, Nimmo G, Stylianopoulos T,

> Gottlieb T. Community-acquired methicillin-resistant

Staphylococcus

> aureus in Australia. Australian Group on Antimicrobial Resistance.

> Lancet 1998; 352:145-6.

> 13. Groos A, Naimi T, Wolset D, - K, K, Cheek J.

> Emergence of community-acquired methicillin-resistant

Staphylococcus

> aureus in a rural American Indian community (Abstract 1230), 39th

> Annual Interscience Conference on Antimicrobial Agents and

> Chemotherapy, San Francisco, CA, 1999.

> 14. Methicillin-resistant Staphylococcus aureus skin or soft

tissue

> infections in a state prison—Mississippi, 2000. MMWR 2001 Oct. 26.

50

> (42); 919-922.

> 15. Lindenmayer JM, Schoenfeld S, O'Grady R, Carney JK.

Methicillin-

> resistant Staphylococcus aureus in a high school wrestling team

and

> the surrounding community. Archives of Internal Medicine 1998;

> 158:895-9.

> 16. Stacey AR, Endersby KE, Chan PC, Marples RR. An outbreak of

> methicillin- resistant Staphylococcus aureus infection in a rugby

> football team. British Journal of Sports Medicine 1998; 332: 153-4.

> 17. Kallen AJ, Driscoll TJ, Thornton S, Olson PE, Wallace MR.

> Increase in community-acquired methicillin-resistant

Staphylococcus

> aureus at a Naval Medical Center. Infection Control and Hospital

> Epidemiology 2000; 21: 223-6

> 18. Hussain FM, Boyle-Vavra S, Bethel CD, Daum RS. Current trends

in

> community-acquired methicillin-resistant Staphylococcus aureus at

a

> tertiary care pediatric facility. Pediatric Infectious Disease

> Journal 2000; 19: 1163-6.

> 19. Feder HM, Jr. Methicillin-resistant Staphylococcus aureus

> infections in 2 pediatric outpatients. Archives of Family Medicine

> 2000; 1163-6.

> 20. Goetz A, Posey K, Fleming J, et al. Methicillin-resistant

> Staphylococcus aureus in the community: a hospital-based study.

> Infection Control and Hospital Epidemiology 1999; 20: 689-91.

> 21. AL, Marcinak JK, Mangat PD, Schreckenberger PC.

Community-

> acquired and clindamycin-susceptible methicillin-resistant

> Staphylococcus aureus in children. Pediatric Infectious Disease

> Journal 1999; 18:993-1000.

> 22. Price MF, McBride ME, Wolf JE, Jr., Prevalence of methicillin-

> resistant Staphylococcus aureus in a dermatology outpatient

> population. Southern Medical Journal 1998: 91:369-71.

> 23. Herold BC, Immergluck LC, Maranan MC, et al. Community-

acquired

> methicillin-resistant Staphylococcus aureus in children with no

> identified predisposing risk. JAMA 1998; 279:593-8.

> 24. From the Centers for Disease Control and Prevention. Four

> pediatric deaths from community-acquired methicillin-resistant

> Staphylococcus aureus—Minnesota and North Dakota, 1997-1999. JAMA

> 1999; 282: 1123-5

[Guest guest]

MRSA is a very nasty bugger for people with CF.

Natalia post a huge sign, very visible, wash hands it prevents

complications! in big letters and red. Same thing with the hospital

room.

> > MRSA - Methicillin Resistant Staphylococcus aureus

> > Fact Sheet

> >

> >

> >

> >

> >

> >

> >

> > The Centers for Disease Control and Prevention (CDC) has received

> > inquiries about infections with antibiotic-resistant

> Staphylococcus

> > aureus (including methicillin-resistant S. aureus [MRSA]) among

> > persons who have no apparent contact with the healthcare system.

> This

> > fact sheet addresses some of the most frequently asked questions.

> >

> > What is Staphylococcus aureus?

> >

> > Staphylococcus aureus, often referred to simply as " staph, " are

> > bacteria commonly carried on the skin or in the nose of healthy

> > people. Occasionally, staph can cause an infection; staph

bacteria

> > are one of the most common causes of skin infections in the

United

> > States. Most of these infections are minor (such as pimples and

> > boils) and most can be treated without antibiotics (also known as

> > antimicrobials or antibacterials). However, staph bacteria can

> also

> > cause serious infections (such as surgical wound infections and

> > pneumonia). In the past, most serious staph bacteria infections

> were

> > treated with a certain type of antibiotic related to penicillin.

> Over

> > the past 50 years, treatment of these infections has become more

> > difficult because staph bacteria have become resistant to various

> > antibiotics, including the commonly used penicillin-related

> > antibiotics (1). These resistant bacteria are called methicillin-

> > resistant Staphylococcus aureus, or MRSA.

> >

> > Where are staph and MRSA found?

> >

> > Staph bacteria and MRSA can be found on the skin and in the nose

> of

> > some people without causing illness. Top

> >

> > What is the difference between colonization and infection?

> >

> > Colonization occurs when the staph bacteria are present on or in

> the

> > body without causing illness. Approximately 25 to 30% of the

> > population is colonized in the nose with staph bacteria at a

given

> > time (2).

> > Infection occurs when the staph bacteria cause disease in the

> person.

> > People also may be colonized or infected with MRSA, the staph

> > bacteria that are resistant to many antibiotics. Top

> >

> > Who gets MRSA?

> >

> > Staph bacteria can cause different kinds of illness, including

> skin

> > infections, bone infections, pneumonia, severe life-threatening

> > bloodstream infections, and others. Since MRSA is a staph

> bacterium,

> > it can cause the same kinds of infection as staph in general;

> > however, MRSA occurs more commonly among persons in hospitals and

> > healthcare facilities.

> > MRSA infection usually develops in hospitalized patients who are

> > elderly or very sick or who have an open wound (such as a

bedsore)

> or

> > a tube going into their body (such as a urinary catheter or

> > intravenous [iV] catheter). MRSA infections acquired in hospitals

> and

> > healthcare settings can be severe. In addition, certain factors

> can

> > put some patients at higher risk for MRSA including prolonged

> > hospital stay, receiving broad-spectrum antibiotics, being

> > hospitalized in an intensive care or burn unit, spending time

> close

> > to other patients with MRSA, having recent surgery, or carrying

> MRSA

> > in the nose without developing illness (3-6).

> >

> > MRSA causes illness in persons outside of hospitals and

healthcare

> > facilities as well. Cases of MRSA diseases in the community have

> been

> > associated with recent antibiotic use, sharing contaminated

items,

> > having active skin diseases, and living in crowded settings.

> Clusters

> > of skin infections caused by MRSA have been described among

> injecting

> > drug-users (7,8), aboriginals in Canada (9), New Zealand (10) or

> > Australia (11,12), Native Americans in the United States (13),

> > incarcerated persons (14), players of close-contact sports

(15,16)

> > and other populations (17-23). Community-associated MRSA

> infections

> > are typically skin infections, but also can cause severe illness

> as

> > in the cases of four children who died from community-associated

> MRSA

> > (24). Most of the transmission in these settings appeared to be

> from

> > people with active MRSA skin infections. Top

> >

> > How common is staph and MRSA?

> >

> > Staph bacteria are one of the most common causes of skin

infection

> in

> > the United States, and are a common cause of pneumonia and

> > bloodstream infections. Staph and MRSA infections are not

> routinely

> > reported to public health authorities, so a precise number is not

> > known. According to some estimates, as many as 100,000 persons

are

> > hospitalized each year with MRSA infections, although only a

small

> > proportion of these persons have disease onset occurring in the

> > community. Approximately 25 to 30% of the population is colonized

> in

> > the nose with staph bacteria at a given time (2). The numbers who

> are

> > colonized with MRSA at any one time is not known. CDC is

currently

> > collaborating with state and local health departments to improve

> > surveillance for MRSA. Active, population-based surveillance in

> > selected regions of the United States is ongoing and will help

> > characterize the scope and risk factors for MRSA in the

community.

> Top

> >

> > Are staph and MRSA infections treatable?

> >

> > Yes. Most staph bacteria and MRSA are susceptible to several

> > antibiotics. Furthermore, most staph skin infections can be

> treated

> > without antibiotics by draining the sore. However, if antibiotics

> are

> > prescribed, patients should complete the full course and call

> their

> > doctors if the infection does not get better. Patients who are

> only

> > colonized with staph bacteria or MRSA usually do not need

> treatment.

> > Top

> >

> > How are staph and MRSA spread?

> >

> > Staph bacteria and MRSA can spread among people having close

> contact

> > with infected people. MRSA is almost always spread by direct

> physical

> > contact, and not through the air. Spread may also occur through

> > indirect contact by touching objects (i.e., towels, sheets, wound

> > dressings, clothes, workout areas, sports equipment) contaminated

> by

> > the infected skin of a person with MRSA or staph bacteria. Top

> >

> > How can I prevent staph or MRSA infections?

> >

> > Practice good hygiene

> >

> > 1. Keep your hands clean by washing thoroughly with soap and water

> >

> > 2. Keep cuts and abrasions clean and covered with a proper

> dressing

> > (e.g., bandage) until healed

> >

> > 3. Avoid contact with other people's wounds or material

> contaminated

> > from wounds.

> >

> > What should I do if I think I have a Staph or MRSA infection?

> >

> > See your healthcare provider.

> >

> > What is CDC doing to address MRSA in the community?

> >

> > CDC is concerned about MRSA in communities and is working with

> > multiple partners on prevention strategies.

> >

> > CDC is working with 4 states in a project to define the spectrum

> of

> > disease, determine populations affected, and developing studies

to

> > define who is at particular risk for infection

> > CDC is working with state health departments to assist in the

> > development of surveillance systems for tracking MRSA in the

> > community

> > CDC is using the National Health and Nutritional Evaluation

Survey

> > (NHANES) to estimate the number of individuals in the United

> States

> > who carry staph bacteria in their nose

> > CDC works with laboratories across the country to improve the

> > detection of MRSA through training personnel and use of

> appropriate

> > testing methods

> > CDC provides technical expertise to hospitals and state and local

> > health departments on infection control in healthcare settings,

> > including control of MRSA

> > CDC laboratories are working to characterize the unique features

> of

> > MRSA strains from the community.

> > Top

> >

> >

> > References:

> > 1. Lowry FD. Staphylococcus aureus infections. New England

Journal

> of

> > Medicine. 1998;339:520-32.

> > 2. Kluytmans J, Van Belkum A, Verbrugh H. Nasal carriage of

> > Staphylococcus aureus: epidemiology, underlying mechanisms, and

> > associated risks. Clin Microbiol Rev. 1997;10:505-20.

> > 3. Boyce JM. Methicillin-resistant Staphylococcus aureus.

> Detection,

> > epidemiology, and control measures. Infect Dis Clinics of North

> Am.

> > 1989;3:901-13.

> > 4. Herwaldt LA. Control of methicillin-resistant Staphylococcus

> > aureus in the hospital setting. Am J Medicine. 1999;106:11S-18S;

> > discussion 48S-52S.

> > 5. Asensio A, Guerrero A, Quereda C, Lizan M, ez-Ferrer M.

> > Colonization and infection with methicillin-resistant

> Staphylococcus

> > aureus: associated factors and eradication. Infec Control Hosp

> > Epidemiol. 1996;17:20-8.

> > 6. Mulligan ME, Murray-Leisure KA, Ribner BD, et al. Methicillin-

> > resistant Staphylococcus aureus: a consensus review of the

> > microbiology, pathogenesis, and epidemiology with implications

for

> > prevention and management. Am J Medicine. 1993;94:313-28.

> > 7. Saravolatz LD, Markowitz N, Arking L, Pohloh D, Fisher E.

> > Methicillin-resistant Staphylococcus aureus. Epidemiologic

> > oberservations during a community-acquired outbreak. ls of

> > Internal Medicine. 1982;96:11-16.

> > 8. CDC. Community-acquired methicillin-resistant Staphylococcus

> > aureus infections—Michigan. MMWR. 1981;30:185-7.

> > 9. Embil J, Ramotar K, Romance L, et al. Methicillin-resistant

> > Staphylococcus aureus in tertiary care institutions on the

> Canadian

> > prairies 1990-1992. Infection Control and Hospital Epidemiology

> 1994;

> > 15:646-51.

> > 10. Rings T, Findlay R, Lang S. Ethnicity and methicillin-

> resistant

> > S. aureus in South Auckland. New Zealand Medical Journal 1998;

> > 111:151.

> > 11. Maguire GP, Arthur AD, Boustead PJ, Dwyer B, Currie BJ.

> Emerging

> > epidemic of community-acquired methicillin-resistant

> Staphylococcus

> > aureus infection in the Northern Territory. Medical Journal of

> > Australia 1996; 1996; 164:721-3.

> > 12. Collignon P, Gosbell I, Vickery A, Nimmo G, Stylianopoulos T,

> > Gottlieb T. Community-acquired methicillin-resistant

> Staphylococcus

> > aureus in Australia. Australian Group on Antimicrobial

Resistance.

> > Lancet 1998; 352:145-6.

> > 13. Groos A, Naimi T, Wolset D, - K, K, Cheek

J.

> > Emergence of community-acquired methicillin-resistant

> Staphylococcus

> > aureus in a rural American Indian community (Abstract 1230), 39th

> > Annual Interscience Conference on Antimicrobial Agents and

> > Chemotherapy, San Francisco, CA, 1999.

> > 14. Methicillin-resistant Staphylococcus aureus skin or soft

> tissue

> > infections in a state prison—Mississippi, 2000. MMWR 2001 Oct.

26.

> 50

> > (42); 919-922.

> > 15. Lindenmayer JM, Schoenfeld S, O'Grady R, Carney JK.

> Methicillin-

> > resistant Staphylococcus aureus in a high school wrestling team

> and

> > the surrounding community. Archives of Internal Medicine 1998;

> > 158:895-9.

> > 16. Stacey AR, Endersby KE, Chan PC, Marples RR. An outbreak of

> > methicillin- resistant Staphylococcus aureus infection in a rugby

> > football team. British Journal of Sports Medicine 1998; 332: 153-

4.

> > 17. Kallen AJ, Driscoll TJ, Thornton S, Olson PE, Wallace MR.

> > Increase in community-acquired methicillin-resistant

> Staphylococcus

> > aureus at a Naval Medical Center. Infection Control and Hospital

> > Epidemiology 2000; 21: 223-6

> > 18. Hussain FM, Boyle-Vavra S, Bethel CD, Daum RS. Current trends

> in

> > community-acquired methicillin-resistant Staphylococcus aureus at

> a

> > tertiary care pediatric facility. Pediatric Infectious Disease

> > Journal 2000; 19: 1163-6.

> > 19. Feder HM, Jr. Methicillin-resistant Staphylococcus aureus

> > infections in 2 pediatric outpatients. Archives of Family

Medicine

> > 2000; 1163-6.

> > 20. Goetz A, Posey K, Fleming J, et al. Methicillin-resistant

> > Staphylococcus aureus in the community: a hospital-based study.

> > Infection Control and Hospital Epidemiology 1999; 20: 689-91.

> > 21. AL, Marcinak JK, Mangat PD, Schreckenberger PC.

> Community-

> > acquired and clindamycin-susceptible methicillin-resistant

> > Staphylococcus aureus in children. Pediatric Infectious Disease

> > Journal 1999; 18:993-1000.

> > 22. Price MF, McBride ME, Wolf JE, Jr., Prevalence of methicillin-

> > resistant Staphylococcus aureus in a dermatology outpatient

> > population. Southern Medical Journal 1998: 91:369-71.

> > 23. Herold BC, Immergluck LC, Maranan MC, et al. Community-

> acquired

> > methicillin-resistant Staphylococcus aureus in children with no

> > identified predisposing risk. JAMA 1998; 279:593-8.

> > 24. From the Centers for Disease Control and Prevention. Four

> > pediatric deaths from community-acquired methicillin-resistant

> > Staphylococcus aureus—Minnesota and North Dakota, 1997-1999. JAMA

> > 1999; 282: 1123-5