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Background: Reports from various geographic regions indicate that the prevalence of community-acquired methicillin-resistant (MRSA) infection is increasing. The primary reservoir is the anterior nares; nasal carriage is a risk factor for infection in a variety of populations. Little is known about MRSA nasal carriage rates among children in Nashville, TN and the associated likelihood of community MRSA transmission., Methods: Nasal swabs were collected from 500 children at well-child visits at either a university hospital pediatric clinic or a private pediatric office. Cultures were plated onto selective staphylococcal media, with or without oxacillin. isolates were confirmed by coagulase tube testing. Antibiotic susceptibilities were determined for suspected methicillin-resistant isolates by standard broth microdilution methods (National Committee for Clinical Laboratory Standards). Pulsed field gel electrophoresis was used to evaluate epidemiologic relatedness. PCR testing was done to assess for the gene. A parent questionnaire was administered regarding MRSA risk factors., Results: Four patients had oxacillin-resistant isolates (MIC >or= 4 microg/ml), and two had borderline resistant isolates (MICs = 1 and 2 microg/ml). One of the borderline-resistant isolates and one of the MRSA isolates had pulsed field gel electrophoresis typing results indicating close relatedness. The gene was present in all resistant isolates and one of the borderline-resistant isolates. Only having a household member employed in a hospital was associated with a greater risk of MRSA nasal carriage (odds ratio, 9.6; P= 0.008)., Conclusions: MRSA nasal colonization is present within Nashville's healthy pediatric population. Children with household contacts employed in a hospital are significantly more likely to be colonized.

Eighty-eight patients consecutively admitted to an alcohol treatment program were studied to determine the amount of depressive symptoms on entry to the program and after 4 weeks of treatment. The degree of symptoms was in turn related to various aspects of their drinking behavior. Twenty-two of the patients were classified as having moderate to marked depressive symptoms, 40 had mild symptoms, and 26 had no significant symptoms at the time of entry into the program. Factors in drinking behavior that best characterized those with moderate to marked symptoms were addiction, sleep disturbance, hangover incapacitation, loss of control, neurological signs, and organicity/toxicity. At the end of treatment, only four patients could actually be diagnosed as depressed, while 12 had mild residual symptoms and 72 no longer had significant symptoms. The one factor that clearly distinguished those patients with residual depressive symptoms was the use of drinking for social facilitation. For such individuals, bars and drinking were the focus of social life. The favorable course of depressive symptoms in alcoholics soon after they stop drinking suggests that they are more likely the consequence of drinking than the cause of it. The fact that patients who drink primarily to facilitate social aspects of their lives were the most likely to have residual symptoms suggests that treatment of such individuals should involve development of alternative mechanisms of social interaction.