Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) surveillance among Army active duty personnel, Fort Benning GA, 2007-2010

Background: An increasing number of S. aureus infections demonstrate antibiotic resistance. Military populations that experience crowding and suboptimal personal hygiene are at increased risk of CA-MRSA infection, though this may vary according to geographic location and duty status. High prevalence of CA-MRSA infection among Army active duty personnel was documented at Fort Benning GA from 2002 through 2007. Methods: To update the prior CA-MRSA assessment at Fort Benning, antibiotic susceptibility, infection rates, and treatment regimens among assigned active duty members and trainees from January 2007-December 2010 were analyzed using active medical surveillance and laboratory data. Results: A total of 2,828 CA-MRSA infections were identified, resulting in 6,966 MRSA-related clinic visits. Each infection resulted in an average of three clinic visits, and 6% of infections required hospitalization. Approximately 44% received antibiotics and wound drainage; of those prescribed antibiotics, 99% received at least one effective antibiotic. Most infections occurred in those under 25 years of age. Approximately 56% of isolates were from units participating in one-stop unit training. Seasonal distribution (peaking in summer months) was observed and antibiotic susceptibility patterns remained largely comparable to those publicly reported. Conclusion: The continued high prevalence of CA-MRSA among trainees underscores the need for improved personal hygiene, disinfection of common surfaces, increased provider awareness, and appropriate treatment/wound care. Further research regarding MRSA carriage rates among incoming trainees and specific training activities associated with infection may be useful in reducing the disease burden.