"A Model for Surveillance of Methicillin-Resistant Staphylococcus Aureus," by authors Ms. Hannah Simons and Dr. Philip Alcabes appears in the "Practice Articles" section of the first 2008 issue of Public Health Reports. The article addresses methicillin-resistant Staphylococcus aureus (MRSA) as a community pathogen and attempts to distinguish the differences between community-associated and hospital-associated MRSA strains. Some of these differences include distinct methicillin resistance genes and genetic backgrounds and differing susceptibilities to antibiotics. The best methods for population-level detection and containment of these strains have not yet been established.

In the article, the researchers reviewed literature on hospital-associated and community-associated MRSA (CA-MRSA) and proposed a model for enhanced surveillance. Critical advances, such as molecular characterization of the SCCmec region, have allowed for a greater understanding of the origins and epidemiology of CA-MRSA. Surveillance is the first step in detection.

In conclusion, the authors state that the spread of MRSA is a dynamic phenomenon. "The rapid evolution of S. aureus necessitates consistent monitoring prevalence, distribution, and resistance patterns in the community and hospital." In order to achieve control of MRSA, all sectors of the health care field – from clinicians to researchers to public health officials – must continue to link knowledge of the microbiological and epidemiological dimensions of CA-MRSA with efforts to devise timely and appropriate population-level solutions

This practice article and other viewpoint and research articles are available in the January/February 2008 issue of Public Health Reports. For more information or to subscribe to Public Health Reports, visit www.publichealthreports.org.