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Direct-Contact Pathogens

Some pathogens are spread by skin-to-skin contact. In Chapter 1, “Introduction to the Resistance Problem,” we briefly described situations involving S. aureus. Although hospital outbreaks of MRSA have been common since the 1970s, community-associated forms began to emerge only in the late 1990s. Examples involving military recruits and sports teams are consistent with transmission occurring by skin-to-skin contact and sharing personal items (see Box 7-8).


Box 7-8: Spread of MRSA

Military recruits at training facilities are at risk for community-associated (CA) MRSA. Between October 2000 and June 2002, a large U.S. military facility recorded 235 cases of CA-MRSA. In November 2002, military authorities implemented a variety of hygienic measures including an emphasis on hand washing and showering. In addition, sharing personal items was prohibited, and antibiotic therapy was instituted to eliminate nasal colonization. The outbreak ended in December 2002. In many of these cases, infections were on arms and legs where skin abrasions were expected from training exercises.168


  

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