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Volume 15, Number 10—October 2009

CME ACTIVITY - Research

Community-Associated Methicillin-Resistant Staphylococcus aureus, Iowa, USA

Earning CME Credit

To obtain credit, you should first read the journal article. After reading the article, you should be able to answer the following, related, multiple-choice questions. To complete the questions and earn continuing medical education (CME) credit, please go to http://www.medscape.com/cme/eid. Credit cannot be obtained for tests completed on paper, although you may use the worksheet below to keep a record of your answers. You must be a registered user on Medscape.com. If you are not registered on Medscape.com, please click on the New Users: Free Registration link on the left hand side of the website to register. Only one answer is correct for each question. Once you successfully answer all post-test questions you will be able to view and/or print your certificate. For questions regarding the content of this activity, contact the accredited provider, CME@medscape.net. For technical assistance, contact CME@webmd.net. American Medical Association’s Physician’s Recognition Award (AMA PRA) credits are accepted in the US as evidence of participation in CME activities. For further information on this award, please refer to http://www.ama-assn.org/ama/pub/category/2922.html. The AMA has determined that physicians not licensed in the US who participate in this CME activity are eligible for AMA PRA Category 1 Credits™. Through agreements that the AMA has made with agencies in some countries, AMA PRA credit is acceptable as evidence of participation in CME activities. If you are not licensed in the US and want to obtain an AMA PRA CME credit, please complete the questions online, print the certificate and present it to your national medical association.

Article Title: Community-Associated Methicillin-Resistant Staphylococcus aureus, Iowa, USA

CME Questions

1. A 25-year-old man is admitted to the intensive care unit with head trauma after a motor vehicle accident, receives a urinary catheter, and is ventilated. He receives prophylactic antibiotics for multiple skin wounds. Which of the following is least likely to be a risk factor for healthcare-associated (HA) verus community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) in this patient?

A. Young age

B. Hospitalization

C. Catheter use

D. Exposure to antimicrobials

2. Which of the following best describes the definition of multiresistant isolates of MRSA?

A. Resistant to more than 4 of 8 antimicrobial classes

B. Resistant to more than 2 of 7 antimicrobial classes

C. Resistant to more than 3 of 8 antimicrobial classes

D. Resistant to more than 3 of 7 antimicrobial classes

3. Which of the following most accurately describes the trend in CA-MRSA USA300/400 infection in 1 US state from 1999 to 2006?

A. Most USA300/400 isolates were from the skin

B. Distribution of MRSA strains varied according to body site

C. The rate of nosocomial infections increased significantly

D. USA300/400 isolates did not demonstrate multidrug resistance

4. A 64-year-old man in a long-term care facility is admitted to the hospital in the summer for acute stroke. Which of the following is most likely to be a significant positive predictor of CA-MRSA compared with HA-MRSA in this patient?

A. Admission in summer versus other season

B. Age younger than 69 years

C. Hospitalization

D. Concurrent urinary tract infection

5. Which of the following best describes recent patterns of CA-MRSA infection in the United States?

A. Increase in incidence of USA300 strain of MRSA

B. Over 50% of CA-MRSA infections are invasive

C. USA300 is associated with 60% of MRSA bloodstream infections

D. Decrease in urban areas and increase in rural areas

Activity Evaluation

1. The activity supported the learning objectives.

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2. The material was organized clearly for learning to occur.

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3. The content learned from this activity will impact my practice.

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4. The activity was presented objectively and free of commercial bias.

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