In 2008, the newswires were rife with reports about an outbreak of a new strain of the flesh-eating MRSA bacteria mainly among gay and bisexual men in San Francisco and Boston. AlthoughMRSA (methicillin-resistantStaphylococcus aureus)has long been considered a major public health threat, it was rarely associated with such a rapid and specific outbreak.
In San Francisco alone, 532 MRSA infections were confirmed. What made the 2008 event so unusual was that many of the reported infections were passed during sexual activity, particularly among men who have sex with men (MSM).
How Bad Can MRSA Infections Get?
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MRSA vs. STIs
How MRSA Is Diagnosed
Factors for Transmission
Most MRSA infections are acquired while in a healthcare facility (known ashealthcare-associated MRSA).This is not only due to improper handwashing or the contamination of wounds and medical devices but also because hospital patients tend to be immune suppressed and less able to fight infection.
HIV Infection
When MRSA occurs outside of a healthcare facility, is it known ascommunity-acquired MRSA. By and large, people who are immune-suppressed—such as the elderly or people living with HIV (human immunodeficiency virus)—are more likely to become infected than those with healthyimmune systems.
According to theSan Francisco Department of Public Health, the Castro District had anHIV incidenceof 181 out of every 100,000 residents in 2017.
Prevention
Despite the risk of sexual exposure, MRSA is a rare occurrence even in groups considered to be at higher risk.While every effort should be taken to avoid spreading diseases through sexual networks, the larger concerns are the everyday routes through which MRSA can be spread.
As a rule of thumb, personal hygiene should prevail when it comes to preventing MRSA and other community-transmitted bacteria. Among the precautions:
If you have HIV, you should immediately start and adhere to antiretroviral therapy (ART, a combination of HIV medicines). Doing so not only suppresses the virus but allows your body to rebuild its immune defenses.
8 Serious Infections You Can Get in Hospital
3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Diep BA, Chambers HF, Graber CJ, et al.Emergence of multidrug-resistant, community-associated, methicillin-resistantstaphylococcus aureusclone usa300 in men who have sex with men.Ann Intern Med. 2008;148(4):249. doi:10.7326/0003-4819-148-4-200802190-00204Hassoun A, Linden PK, Friedman B.Incidence, prevalence, and management of MRSA bacteremia across patient populations-a review of recent developments in MRSA management and treatment. Crit Care. 2017;21(1):211. doi:10.1186/s13054-017-1801-3New York State Department of Health.MRSA and HIV Infection: How to Protect Yourself.Additional ReadingAntoniou T, Devlin R, Gough K et al.Prevalence of Community-associated Methicillin-resistant Staphylococcus Aureus Colonization in Men Who Have Sex With Men.Int J STD AIDS.2009;20(3):180-3. doi:10.1258/ijsa.2008.008243.Clark T, Marquez C, Hare B et al.Methamphetamine Use, Transmission Risk Behavior and Internet Use Among HIV-Infected Patients in Medical Care, San Francisco, 2008.AIDS Behav.2012 Feb;16(2): 396-403. doi:10.1007/s10461-010-9869-7.Leung NS, Vidoni ML, Robinson DA et al.A Community-Based Study of Staphylococcus aureus Nasal Colonization and Molecular Characterization Among Men Who Have Sex with Men.LGBT Health.2017 Oct;4(5):345-351. doi:10.1089/lgbt.2017.0016.Mediavilla JR, Chen L, Mathema B, Kreiswirth BN.Global epidemiology of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA).Curr Opin Microbiol.2012 Oct;15(5):588-95. doi:10.1016/j.mib.2012.08.003.San Francisco Department of Health Population Health Division. (2018)HIV Epidemiology: Annual Report 2017.San Francisco, California: San Francisco Department of HealthSzumowski JD, Wener KM, Gold HS et al.Methicillin-resistant Staphylococcus aureus colonization, behavioral risk factors, and skin and soft-tissue infection at an ambulatory clinic serving a large population of HIV-infected men who have sex with men.Clin Infect Dis.2009 Jul 1;49(1):118-21. doi:10.1086/599608.
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Diep BA, Chambers HF, Graber CJ, et al.Emergence of multidrug-resistant, community-associated, methicillin-resistantstaphylococcus aureusclone usa300 in men who have sex with men.Ann Intern Med. 2008;148(4):249. doi:10.7326/0003-4819-148-4-200802190-00204Hassoun A, Linden PK, Friedman B.Incidence, prevalence, and management of MRSA bacteremia across patient populations-a review of recent developments in MRSA management and treatment. Crit Care. 2017;21(1):211. doi:10.1186/s13054-017-1801-3New York State Department of Health.MRSA and HIV Infection: How to Protect Yourself.Additional ReadingAntoniou T, Devlin R, Gough K et al.Prevalence of Community-associated Methicillin-resistant Staphylococcus Aureus Colonization in Men Who Have Sex With Men.Int J STD AIDS.2009;20(3):180-3. doi:10.1258/ijsa.2008.008243.Clark T, Marquez C, Hare B et al.Methamphetamine Use, Transmission Risk Behavior and Internet Use Among HIV-Infected Patients in Medical Care, San Francisco, 2008.AIDS Behav.2012 Feb;16(2): 396-403. doi:10.1007/s10461-010-9869-7.Leung NS, Vidoni ML, Robinson DA et al.A Community-Based Study of Staphylococcus aureus Nasal Colonization and Molecular Characterization Among Men Who Have Sex with Men.LGBT Health.2017 Oct;4(5):345-351. doi:10.1089/lgbt.2017.0016.Mediavilla JR, Chen L, Mathema B, Kreiswirth BN.Global epidemiology of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA).Curr Opin Microbiol.2012 Oct;15(5):588-95. doi:10.1016/j.mib.2012.08.003.San Francisco Department of Health Population Health Division. (2018)HIV Epidemiology: Annual Report 2017.San Francisco, California: San Francisco Department of HealthSzumowski JD, Wener KM, Gold HS et al.Methicillin-resistant Staphylococcus aureus colonization, behavioral risk factors, and skin and soft-tissue infection at an ambulatory clinic serving a large population of HIV-infected men who have sex with men.Clin Infect Dis.2009 Jul 1;49(1):118-21. doi:10.1086/599608.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Diep BA, Chambers HF, Graber CJ, et al.Emergence of multidrug-resistant, community-associated, methicillin-resistantstaphylococcus aureusclone usa300 in men who have sex with men.Ann Intern Med. 2008;148(4):249. doi:10.7326/0003-4819-148-4-200802190-00204Hassoun A, Linden PK, Friedman B.Incidence, prevalence, and management of MRSA bacteremia across patient populations-a review of recent developments in MRSA management and treatment. Crit Care. 2017;21(1):211. doi:10.1186/s13054-017-1801-3New York State Department of Health.MRSA and HIV Infection: How to Protect Yourself.
Diep BA, Chambers HF, Graber CJ, et al.Emergence of multidrug-resistant, community-associated, methicillin-resistantstaphylococcus aureusclone usa300 in men who have sex with men.Ann Intern Med. 2008;148(4):249. doi:10.7326/0003-4819-148-4-200802190-00204
Hassoun A, Linden PK, Friedman B.Incidence, prevalence, and management of MRSA bacteremia across patient populations-a review of recent developments in MRSA management and treatment. Crit Care. 2017;21(1):211. doi:10.1186/s13054-017-1801-3
New York State Department of Health.MRSA and HIV Infection: How to Protect Yourself.
Antoniou T, Devlin R, Gough K et al.Prevalence of Community-associated Methicillin-resistant Staphylococcus Aureus Colonization in Men Who Have Sex With Men.Int J STD AIDS.2009;20(3):180-3. doi:10.1258/ijsa.2008.008243.Clark T, Marquez C, Hare B et al.Methamphetamine Use, Transmission Risk Behavior and Internet Use Among HIV-Infected Patients in Medical Care, San Francisco, 2008.AIDS Behav.2012 Feb;16(2): 396-403. doi:10.1007/s10461-010-9869-7.Leung NS, Vidoni ML, Robinson DA et al.A Community-Based Study of Staphylococcus aureus Nasal Colonization and Molecular Characterization Among Men Who Have Sex with Men.LGBT Health.2017 Oct;4(5):345-351. doi:10.1089/lgbt.2017.0016.Mediavilla JR, Chen L, Mathema B, Kreiswirth BN.Global epidemiology of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA).Curr Opin Microbiol.2012 Oct;15(5):588-95. doi:10.1016/j.mib.2012.08.003.San Francisco Department of Health Population Health Division. (2018)HIV Epidemiology: Annual Report 2017.San Francisco, California: San Francisco Department of HealthSzumowski JD, Wener KM, Gold HS et al.Methicillin-resistant Staphylococcus aureus colonization, behavioral risk factors, and skin and soft-tissue infection at an ambulatory clinic serving a large population of HIV-infected men who have sex with men.Clin Infect Dis.2009 Jul 1;49(1):118-21. doi:10.1086/599608.
Antoniou T, Devlin R, Gough K et al.Prevalence of Community-associated Methicillin-resistant Staphylococcus Aureus Colonization in Men Who Have Sex With Men.Int J STD AIDS.2009;20(3):180-3. doi:10.1258/ijsa.2008.008243.
Clark T, Marquez C, Hare B et al.Methamphetamine Use, Transmission Risk Behavior and Internet Use Among HIV-Infected Patients in Medical Care, San Francisco, 2008.AIDS Behav.2012 Feb;16(2): 396-403. doi:10.1007/s10461-010-9869-7.
Leung NS, Vidoni ML, Robinson DA et al.A Community-Based Study of Staphylococcus aureus Nasal Colonization and Molecular Characterization Among Men Who Have Sex with Men.LGBT Health.2017 Oct;4(5):345-351. doi:10.1089/lgbt.2017.0016.
Mediavilla JR, Chen L, Mathema B, Kreiswirth BN.Global epidemiology of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA).Curr Opin Microbiol.2012 Oct;15(5):588-95. doi:10.1016/j.mib.2012.08.003.
San Francisco Department of Health Population Health Division. (2018)HIV Epidemiology: Annual Report 2017.San Francisco, California: San Francisco Department of Health
Szumowski JD, Wener KM, Gold HS et al.Methicillin-resistant Staphylococcus aureus colonization, behavioral risk factors, and skin and soft-tissue infection at an ambulatory clinic serving a large population of HIV-infected men who have sex with men.Clin Infect Dis.2009 Jul 1;49(1):118-21. doi:10.1086/599608.
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