Brooklyn enclave shows how communities drive antibiotic resistance

A recent spread of community-acquired methicillin-resistant Staphylococcus aureus in a New York City enclave is helping medical experts understand how high-risk populations can prompt antimicrobial resistance.

In 2016, a team of researchers led by the NYU School of Medicine said they began seeing an increasing number of community-acquired MRSA-related skin infections in infants and young children from Brooklyn's Orthodox Jewish communities.

A preliminary investigation found a unique strain of community-acquired MRSA was spreading throughout the population — similar to what would take place during a hospital outbreak.

The researchers also found MRSA transmission was occurring through the gastrointestinal tract, and this specific strain of community-acquired MRSA accumulated genes that increased virulence and had resistance to the two topical treatments most often used for decolonization and infection prevention.

Genomic surveillance, which helped identify this bacterial cluster and improves infection control in hospitals, should be applied more vigilantly to community-based pathogen surveillance, the researchers concluded.

"Our experience in Brooklyn suggests that hospital-based genomic surveillance data can be applied to bridge the divide between hospital and community epidemiology, and therefore make it easier to identify and respond to community-based disease clusters," said senior study author Bo Shopsin, MD, PhD. "Follow-up infection control strategies could help prevent further spread of antimicrobial-resistant pathogens such as [community-acquired] MRSA."

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