Epidemiology

staphylococcus aureus is commonly carried on the skin or in the nose of healthy people. Approximately 25-30% of the population is colonized with the bacteria but remain well (43). From time to time, the bacteria cause minor skin infections that usually do not require antibiotic treatment. However, more serious problems can occur (e.g., infection of surgical wounds, drug injection sites, osteomyelitis, pneumonia, or septicemia). During the last 50 years, the bacteria have become increasingly resistant to penicillin-based antibiotics (44), and in the last 20 years, they have become resistant to an increasing number of alternative antibiotics. These multiresistant bacteria are known as methicillin-resistant S. aureus (MRSA).

MRSA is prevalent worldwide. Like nonresistant staphylococci, it may remain undetected as a reservoir in colonized individuals but can also produce clinical disease. It is more common in individuals who are elderly, debilitated, or immunocompromised or those with open wounds. Clusters of skin infections with MRSA have been reported among injecting drug users (IDUs) since 1981 in America (45,46), and more recently, similar strains have been found in the United Kingdom in IDUs in the community (47). This may have particular relevance for the forensic physician when dealing with IDUs sores. People who are immunocompetent rarely get MRSA and should not be considered at risk.

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