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22 Mar 2018

Julie was proud and excited about her new tattoo; it was cool! Jason, her boyfriend, had bought it as a gift for her 18th birthday, and she loved the way it covered her arm. A week later something else covered her arm … and his leg. Julie and Jason had fallen victim to an emerging disease—community-associated, methicillin-resistant Staphylococcus aureus (CA-MRSA) infection. Julie’s arm was covered with red, swollen, painful, pus-containing lesions, and she had a fever. Jason thought he had a spider bite on Wednesday, but by Thursday morning a bright red line extended from his ankle to his groin. He could barely walk, and then his condition worsened. By the weekend, he was hospitalized, and his fever hit 107°F107°F during his 10 days there. MRSA had entered his blood (bacteremia) and infected his bones (osteomyelitis). Jason’s pain was so severe that he wondered only when he might die to be free of the agony. Click for more options Click for more options For years, health care workers have battled healthcare-associated MRSA (HA-MRSA), which commonly afflicts patients in hospitals. Now, researchers are concerned that victims who have never been in a hospital are succumbing; MRSA has escaped hospitals and travels communities worldwide, including among athletes, students in middle schools, and customers of unsafe tattooists. The bacterium can be spread between individuals who share fomites—towels, razors, clothing, or sheets. Physicians drained Julie’s lesions and prescribed oral antimicrobials, including trimethoprim-sulfamethoxazole, doxycycline, and clindamycin. Jason received intravenous vancomycin. Both eventually recovered, but her tattoo is now a reminder of a terrible experience and not a happy birthday. (For more about staphylococcal infections, see Chapter 19.) 1. How were Julie and then Jason likely infected? 2. Why is CA-MRSA considered an “emerging disease,” given that MRSA has been around for years? 3. Why doesn’t the map show more countries in Africa and South America with cases of CA-MRSA?

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Keith Leannon
Keith LeannonLv2
22 Mar 2018

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