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BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39465.409051.80 (Published 24 January 2008) Cite this as: BMJ 2008;336:182

New resistant MRSA clone spreads through gay community in San Francisco

A new clone of methicillin resistant Staphylococcus aureus (MRSA) has recently emerged in the US, and researchers suspect it is being sexually transmitted between men who have sex with men. The clone is community acquired and resistant to multiple classes of antibiotics, including recommended treatments for regular community acquired MRSA, such as clindamycin and tetracycline.

Researchers studying the epidemiology of the multidrug resistant USA300 strain in San Francisco found the highest incidences in areas where men who have sex with men tend to live. Male-male sex was an independent risk factor for infection in populations from San Francisco and Boston. A considerable number of infections with the new clone affected the buttocks, genitals, and perineum.

The epicentre of new infections seems to be the Castro district of San Francisco, where more than a quarter of all couples are male, say the researchers. Here, the incidence of infections caused by the new clone is 170 cases/100 000 persons (95% CI 41 to 299), compared with only 4 cases/100 000 persons (0 to 8) in districts with the lowest proportion of male couples.

Selective reporting of antidepressant trials inflates efficacy by a third

Publication bias is a well known problem. Trials with positive results are more likely to be published than trials with negative results, so that treatments sometimes look better in the published literature than they really are. When researchers from the US looked for publication bias in trials of antidepressants they found that the published data overestimated the efficacy of these drugs by nearly a third.

The researchers started with all antidepressant trials registered with the Food and Drug Administration for licensing purposes, then they looked …

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