A literature review on community-acquired methicillin-resistant Staphylococcus aureus in the United States: Clinical information for primary care nurse practitioners

PURPOSE: To analyze the state of the science of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in the United States to support the integration of current knowledge for primary care nurse practitioners' (PCNP) practice. DATA SOURCES: Published research limited to U.S. studies in MEDLINE, CINAHL, and Cochrane Review from 1950 to the week of September 4, 2008. Investigations were identified through electronic search engines and databases. Manual searches were done of hard copy references in journal articles. Citations and reference lists for English language research studies of CA-MRSA in the United States were reviewed to identify additional research that fit evaluation criteria for this analysis. CONCLUSIONS: Until the late 1990s, healthcare-associated MRSA (HA-MRSA) was the predominant cause of serious infections. Recently, CA-MRSA has caused infections in previously healthy nonhospitalized people. Major demographic and epidemiological differences exist between the two types of resistant bacteria; the emergence of CA-MRSA suggests new implications for primary care. IMPLICATIONS FOR PRACTICE: PCNPs will undoubtedly treat MRSA infections and need a comprehensive understanding of the pathogenicity, diagnosis, and management of CA-MRSA to ensure expedient and appropriate treatment. This will help to prevent invasive disease as a result of improperly treated infections.