Strongyloides Stercoralis Hyperinfection in a Patient with AIDS in Uganda Successfully Treated with Ivermectin

We agree with the suggestion of Shopsin et al. [1] that adding chromosomal and mec DNA genotyping information would help to clarify the derivation of community-onset isolates of MRSA. Our simpler algorithm for categorizing isolates used only information routinely available to clinicians because, in the vast majority of the studies that we reviewed, it appeared that these were the only data available [2]. A classification algorithm based completely on clinical epidemiology would be of value to those without routine access to advanced genotyping techniques. Such a classification strategy would provide some degree of uniformity, which was lacking among the many studies that we reviewed. In addition, in infection-control efforts to prevent the spread of MRSA, accurately determining the reservoir for spread is of more interest than is the actual derivation of individual MRSA isolates. Those considering implementation of a surveillance-culture program to control nosocomial spread should not assume that such testing—and its attendant cost—is routinely necessary for optimal control of MRSA. Control of nosocomial spread by simply identifying carriers and placing them under contact precautions has been repeatedly documented [3–12].