Necrotizing community-acquired methicillin-resistant Staphylococcus aureus pneumonia: an emerging problem in correctional facilities.

Abstract

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin infections have been common in prisons for more than a decade. However, CA-MRSA as a cause of pneumonia has been reported infrequently. This infection can present with flu-like symptoms and rapidly progress, possibly leading to death in a matter of days. Two cases of MRSA community-acquired pneumonia (CAP) associated with influenza-like illness in correctional officers employed in two separate prisons within the California prison system are presented. Both individuals were previously healthy, but one died of this disease. MRSA is an uncommon, but now recognized, cause of CAP. These cases are notable for their unique presentation and occurrence in non-health care, occupational settings. Prompt diagnosis and intervention by occupational health nurses and physicians are critical to improving outcomes, especially in high-risk settings such as prisons. These worksites need an effective occupational health program to manage MRSA, with adequate training for both employees and inmates.