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Journal articles on the topic 'Community-associated MRSA'

Author: Grafiati

Published: 7 June 2025

Last updated: 16 July 2025

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1

Holcomb, Susan Simmons. "Community-Associated MRSA." Nurse Practitioner 31, no. 9 (2006): 8,11???12. http://dx.doi.org/10.1097/00006205-200609000-00002.

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Mendyk, Michelle K. "Community-Associated MRSA." Nurse Practitioner 33, no. 3 (2008): 26–32. http://dx.doi.org/10.1097/01.npr.0000312999.38951.ed.

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&NA;. "Community-Associated MRSA." Nurse Practitioner 33, no. 3 (2008): 32–33. http://dx.doi.org/10.1097/01.npr.0000313000.46575.c7.

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Chavez, Temujin T., and Catherine F. Decker. "Health Care-Associated MRSA Versus Community-Associated MRSA." Disease-a-Month 54, no. 12 (2008): 763–68. http://dx.doi.org/10.1016/j.disamonth.2008.09.004.

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5

Hsiao, Ching-Hsi, Sherine Jue Ong, Chih-Chun Chuang, David H. K. Ma, and Yhu-Chering Huang. "A Comparison of Clinical Features between Community-Associated and Healthcare-Associated Methicillin-ResistantStaphylococcus aureusKeratitis." Journal of Ophthalmology 2015 (2015): 1–7. http://dx.doi.org/10.1155/2015/923941.

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Purpose. To compare the clinical features of community-associated (CA) and healthcare-associated (HA) methicillin-resistantStaphylococcus aureus(MRSA) keratitis.Methods. Patients presenting with culture-proven MRSA keratitis between January 1, 2006, and December 31, 2010, at Chang Gung Memorial Hospital, Taiwan, were included in this study. The patients’ demographic and clinical information were reviewed retrospectively. Antibiotic susceptibility was verified using the disk diffusion method.Results. Information on 26 patients with MRSA keratitis was collected, including 12 cases of CA-MRSA and 14 cases of HA-MRSA. All MRSA isolates were susceptible to vancomycin; the only difference in drug susceptibility was that CA-MRSA isolates were more susceptible to trimethoprim/sulfamethoxazole than HA-MRSAP=.034. The most common risk factor for MRSA keratitis was ocular surface disease. No significant differences were observed between the 2 groups in terms of clinical features, treatments, and visual outcomes.Conclusion. In Taiwan, CA-MRSA rivals HA-MRSA as a critical cause of MRSA keratitis. Furthermore, CA-MRSA isolates are multidrug resistant. CA-MRSA and HA-MRSA keratitis are clinically indistinguishable, although larger studies are warranted to further evaluate this association.

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Karvouniaris, Marios, Demosthenes Makris, and Epaminondas Zakynthinos. "Community-associated Staphylococcus aureus infections: pneumonia." Microbiology Research 1, no. 1 (2010): 4. http://dx.doi.org/10.4081/mr.2010.e4.

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Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging health problem with distinct epidemiology. CA-MRSA colonization and infection is associated with risk factors different from healthcare-associated methicillin-resistant S. aureus infection. CA-MRSA strains present different characteristics to healthcare associated strains in terms of microbiology as well. Moreover, infection as a result of CA-MRSA may be associated with severe infections, in particular necrotizing pneumonia. CA-MRSA strains may produce Panton-Valentine leukocidin, a protein that available data suggest to be associated with the severity of the infection. Although the incidence of CA-MRSA pneumonia is relatively low, it affects mostly young, immunocompetent individuals, and in this respect constitutes a serious and potentially lethal form of community-acquired pneumonia. Current treatment suggested by international consensus guidelines includes linezolid or vancomycin often combined with clindamycin and/or rifampicin. However, clinical studies are required to clarify further therapeutic issues on timing, dosing, and choice of optimum treatment, and whether new therapeutic strategies such as vaccination and immunoglobulins could be useful. In the present review we discuss the microbiology, epidemiology, pathogenesis, and clinical aspects of community-acquired pneumonia as a result of CA-MRSA in respect of management and prevention.

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Linde, Hans-Jörg, and Norbert Lehn. "Community-associated MRSA: Klinik, Therapie, Hygiene." Krankenhaushygiene up2date 3, no. 1 (2008): 29–44. http://dx.doi.org/10.1055/s-2007-995561.

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Harris, Allyssa L., and Heidi Collins Fantasia. "Community-Associated MRSA Infections in Women." Journal for Nurse Practitioners 6, no. 6 (2010): 435–41. http://dx.doi.org/10.1016/j.nurpra.2010.02.023.

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&NA;. "THE THREAT OF COMMUNITY-ASSOCIATED MRSA." Advances in Neonatal Care 6, no. 6 (2006): 299. http://dx.doi.org/10.1016/j.adnc.2006.09.005.

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Otto, Michael. "Community-associated MRSA: a dangerous epidemic." Future Microbiology 2, no. 5 (2007): 457–59. http://dx.doi.org/10.2217/17460913.2.5.457.

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11

Millar, B. Cherie, Anne Loughrey, Richard Bill, and John E. Moore. "Community-associated MRSA in primary care." Practice Nursing 22, no. 12 (2011): 662–64. http://dx.doi.org/10.12968/pnur.2011.22.12.662.

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12

Springer, Burkhard. "Community-associated MRSA – the forthcoming epidemic?" Wiener klinische Wochenschrift 121, no. 17-18 (2009): 541–43. http://dx.doi.org/10.1007/s00508-009-1213-8.

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Gonzalez, Blanca E., Adriana M. Rueda, Samuel A. Shelburne, Daniel M. Musher, Richard J. Hamill, and Kristina G. Hultén. "Community-Associated Strains of Methicillin-ResistantStaphylococccus aureusas the Cause of Healthcare-Associated Infection." Infection Control & Hospital Epidemiology 27, no. 10 (2006): 1051–56. http://dx.doi.org/10.1086/507923.

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Objective:Methicillin-resistantStaphylococcus aureus(MRSA) isolates from patients with community-associated infection have been described as strains genetically distinct from the strains isolated from patients with healthcare-associated infection. This study examines the hypothesis that community-associated MRSA (CA-MRSA) strains now cause serious infections in hospitalized patients.Methods.Thirty-seven clinical MRSA isolates were randomly selected from blood isolates obtained from July 2003 through June 2004. Strains were tested for staphylococcal chromosomal cassettemec(SCCmec) type, pulsed-field gel electrophoresis (PFGE) type, and presence of Panton-Valentine leukocidin (PVL) genes. Medical records review and epidemiologic classification was performed by an investigator blinded to the results of the bacterial strain analysis. Episodes of bloodstream infection were independently classified as either community-associated or healthcare-associated infections, and bacterial isolates were independently classified as either CA-MRSA strains or healthcare-associated MRSA (HA-MRSA) strains, according to established definitions.Setting.A tertiary care Veterans Affairs Medical Center.Results.Twenty-four (65%) of 37 MRSA isolates were SCCmectype IV, a genetic type characteristic of CA-MRSA strains; 22 of these 24 isolates belonged to the CA-MRSA clone USA300 and carried PVL genes. Thirteen (35%) of the 37 strains were SCCmectype II, of which 12 were USA100-ST5 and 12 lacked PVL genes. Thirty patients (81%) had healthcare-associated infections; 18 (60%) of these 30 were infected with isolates carrying markers of CA-MRSA strains. Of 7 patients with CA-MRSA infections, 6 were infected with isolates belonging to the USA300 clone. Patients with healthcare-associated bloodstream infections were as likely to be infected with a CA-MRSA strain as patients with a community-associated infection (P= .38).Conclusions.MRSA strains with molecular characteristics of CA-MRSA strains have emerged as an important cause of serious health-care-associated infection in our hospital.

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File, Thomas M. "Methicillin-resistant Staphylococcus aureus (MRSA): focus on community-associated MRSA." Southern African Journal of Epidemiology and Infection 23, no. 2 (2008): 13–15. http://dx.doi.org/10.1080/10158782.2008.11441307.

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Nichol, Kimberly A., Melissa McCracken, Melanie R. DeCorby, et al. "Comparison of Community-Associated and Health Care-Associated Methicillin-ResistantStaphylococcus aureusin Canada: Results from CANWARD 2007." Canadian Journal of Infectious Diseases and Medical Microbiology 20, suppl a (2009): 31A—36A. http://dx.doi.org/10.1155/2009/853676.

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BACKGROUND: Community-associated methicillin-resistantStaphylococcus aureus(CA-MRSA) differ from health care-associated MRSA (HA-MRSA) in their genotypic and phenotypic characteristics. The purpose of the present study was to compare the demographics, antimicrobial susceptibilities and molecular epidemiology of CA-MRSA and HA-MRSA in Canada. METHODS: In 2007, 385 MRSA isolates were collected from Canadian patients attending hospital clinics, emergency rooms, medical/ surgical wards and intensive care units. Susceptibilities to betalactams, clarithromycin, clindamycin, daptomycin, levofloxacin, linezolid, moxifloxacin, tigecycline, trimethoprim-sulfamethoxazole and vancomycin were determined by Clinical and Laboratory Standards Institute broth microdilution. Strain typing was performed by pulsed-field gel electrophoresis (PFGE) and themecA,nucandpvlgenes were detected by polymerase chain reaction. RESULTS: Of the 385 MRSA, 19.5% were CA-MRSA and 79.2% were HA-MRSA as determined by PFGE. CA-MRSA belonged to PFGE types CMRSA10/USA300 (66.7%) and CMRSA7/USA400 (33.3%); PFGE types identified among HA-MRSA included CMRSA2/USA100/800 (81.6%), CMRSA6 (13.1%), CMRSA1/ USA600 (3.3%), CMRSA5/USA500 (1.3%), CMRSA3 (0.3%) and CMRSA9 (0.3%). Panton-Valentine leukocidin (PVL) was detected in 94.7% of CA-MRSA and 0.7% of HA-MRSA. Resistance rates (CA-MRSA versus HA-MRSA) were 61.3% versus 97.7% to levofloxacin, 73.3% versus 96.7% to clarithromycin, 12.0% versus 74.8% to clindamycin and 0.0% versus 15.4% to trimethoprim-sulfamethoxazole. No MRSA were resistant to vancomycin, linezolid, tigecycline or daptomycin. CONCLUSIONS: CA-MRSA represented 19.5% of all MRSA. CA-MRSA was significantly more susceptible to levofloxacin, clarithromycin, clindamycin and trimethoprim-sulfamethoxazole than HA-MRSA. Of CA-MRSA, 94.7% were PVL-positive while 99.3% of HA-MRSA were PVL-negative. CA-MRSA is an emerging pathogen in Canadian hospitals.

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Murphy, Courtney R., Lyndsey O. Hudson, Brian G. Spratt, et al. "Predictors of Hospitals with Endemic Community-Associated Methicillin-ResistantStaphylococcus aureus." Infection Control & Hospital Epidemiology 34, no. 6 (2013): 581–87. http://dx.doi.org/10.1086/670631.

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Objective.We sought to identify hospital characteristics associated with community-associated methicillin-resistantStaphylococcus aureus(CA-MRSA) carriage among inpatients.Design.Prospective cohort study.Setting.Orange County, California.Participants.Thirty hospitals in a single county.Methods.We collected clinical MRSA isolates from inpatients in 30 of 31 hospitals in Orange County, California, from October 2008 through April 2010. We characterized isolates by spa typing to identify CA-MRSA strains. Using California's mandatory hospitalization data set, we identified hospital-level predictors of CA-MRSA isolation.Results.CA-MRSA strains represented 1,033 (46%) of 2,246 of MRSA isolates. By hospital, the median percentage of CA-MRSA isolates was 46% (range, 14%–81%). In multivariate models, CA-MRSA isolation was associated with smaller hospitals (odds ratio [OR], 0.97, or 3% decreased odds of CA-MRSA isolation per 1,000 annual admissions;P<.001), hospitals with more Medicaid-insured patients (OR, 1.2;P= .002), and hospitals with more patients with low comorbidity scores (OR, 1.3;P< .001). Results were similar when restricted to isolates from patients with hospital-onset infection.Conclusions.Among 30 hospitals, CA-MRSA comprised nearly half of MRSA isolates. There was substantial variability in CA-MRSA penetration across hospitals, with more CA-MRSA in smaller hospitals with healthier but socially disadvantaged patient populations. Additional research is needed to determine whether infection control strategies can be successful in targeting CA-MRSA influx.

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Wijaya, Limin, Li-Yang Hsu, and Asok Kurup. "Community-associated Methicillin-resistant Staphylococcus aureus: Overview and Local Situation." Annals of the Academy of Medicine, Singapore 35, no. 7 (2006): 479–86. http://dx.doi.org/10.47102/annals-acadmedsg.v35n7p479.

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Introduction: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged worldwide. In contrast to healthcare-associated MRSA (HA-MRSA), CA-MRSA isolates are usually susceptible to multiple non-beta-lactam antibiotics and cause a distinct spectrum of infections in epidemiologically disparate populations – in particular, cutaneous abscesses, necrotising fasciitis and necrotising pneumonia. They arise from a broader genetic background, and possess differing virulence genes. We aim to describe the distribution of different molecular subtypes of CA-MRSA among various regions and discuss briefly the implications of CA-MRSA from a local perspective. Methods: Literature review of articles on CA-MRSA, focusing mainly on reports where the genetic background of isolates had been analysed using multi-locus sequence typing (MLST). Singapore data were obtained from the local CA-MRSA database. Results: MLST analysis demonstrated the presence of epidemic subtypes of CA-MRSA within most geographic areas. In parts of the United States, community MRSA infections currently exceed those caused by their methicillin-susceptible counterparts. In Singapore, CA-MRSA infections are increasing, predominantly as a result of the spread of ST30 clones. Conclusion: Available evidence suggests that the emergence of MRSA from the community is not going to be a transient phenomenon. Local guidelines for dealing with this phenomenon at both therapeutic and preventive levels are needed prior to the potential development of a situation mirroring that of meso-endemic HA-MRSA in local hospitals or CA-MRSA epidemics in parts of USA. Key words: Bacterial typing, Epidemic, Epidemiology, Infection control

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18

CORONADO, F., J. A. NICHOLAS, B. J. WALLACE, et al. "Community-associated methicillin-resistant Staphylococcus aureus skin infections in a religious community." Epidemiology and Infection 135, no. 3 (2006): 492–501. http://dx.doi.org/10.1017/s0950268806006960.

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In September 2004, an outbreak of community-associated methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTI) was reported among members of a religious community. We conducted a retrospective cohort study on all 175 community members; performed a nasal carriage survey, and environmental swab testing. We identified 24 MRSA cases (attack rate 14%). In multivariate analysis, sauna use [odds ratio (OR) 19·1, 95% confidence interval (CI) 2·7–206·1] and antimicrobial use within 12 months before infection (OR 11·7, 95% CI 2·9–47·6) were risk factors for infection. MRSA nasal carriage rate was 0·6% (1/174). Nine of 10 clinical isolates and an isolate from an administrative office within the community had the pulsed-field gel electrophoresis type USA300. Targeted hygiene improvement, wound care, and environmental cleaning were implemented. We describe the first reported outbreak of MRSA SSTI in a religious community. Adherence to appropriate personal and environmental hygiene might be critical factors in controlling transmission.

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Millar, B. C., B. D. Prendergast, and J. E. Moore. "Community-associated MRSA (CA-MRSA): an emerging pathogen in infective endocarditis." Journal of Antimicrobial Chemotherapy 61, no. 1 (2007): 1–7. http://dx.doi.org/10.1093/jac/dkm410.

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20

Chambers, Henry F. "Community-Associated MRSA — Resistance and Virulence Converge." New England Journal of Medicine 352, no. 14 (2005): 1485–87. http://dx.doi.org/10.1056/nejme058023.

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Hawkes, M., M. Barton, J. Conly, L. Nicolle, C. Barry, and E. L. Ford-Jones. "Community-associated MRSA: Superbug at our doorstep." Canadian Medical Association Journal 176, no. 1 (2006): 54–56. http://dx.doi.org/10.1503/cmaj.061370.

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Tong, Steven YC, and Angela M. Kearns. "Community-associated MRSA from the Indian subcontinent." Lancet Infectious Diseases 13, no. 9 (2013): 734–35. http://dx.doi.org/10.1016/s1473-3099(13)70231-7.

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23

Elston, J. W. T., and G. D. Barlow. "Community-associated MRSA in the United Kingdom." Journal of Infection 59, no. 3 (2009): 149–55. http://dx.doi.org/10.1016/j.jinf.2009.07.001.

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Orsi, G. B., C. M. Mastroianni, A. Giordano, M. Monaco, and M. Venditti. "Lack of community-associated MRSA in Rome." Journal of Hospital Infection 71, no. 4 (2009): 374–76. http://dx.doi.org/10.1016/j.jhin.2008.11.027.

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Kennedy, Adam D., and Frank R. DeLeo. "Epidemiology and Virulence of Community-Associated MRSA." Clinical Microbiology Newsletter 31, no. 20 (2009): 153–60. http://dx.doi.org/10.1016/j.clinmicnews.2009.09.004.

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Otto, Michael. "Community-associated MRSA: What makes them special?" International Journal of Medical Microbiology 303, no. 6-7 (2013): 324–30. http://dx.doi.org/10.1016/j.ijmm.2013.02.007.

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Jeyaratnam, D. "Community associated MRSA: an alert to paediatricians." Archives of Disease in Childhood 91, no. 6 (2006): 511–12. http://dx.doi.org/10.1136/adc.2006.094029.

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Guilbeau, Janis R., and Lisa P. Broussard. "Community-Associated Methicillin-Resistant Staphylococcus aureus (MRSA)." Nursing for Women's Health 14, no. 4 (2010): 310–17. http://dx.doi.org/10.1111/j.1751-486x.2010.01561.x.

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Kobayashi, Scott D., and Frank R. DeLeo. "An update on community-associated MRSA virulence." Current Opinion in Pharmacology 9, no. 5 (2009): 545–51. http://dx.doi.org/10.1016/j.coph.2009.07.009.

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Kawasuji, Hitoshi, Yoshihiro Ikezawa, Mika Morita, et al. "High Incidence of Metastatic Infections in Panton-Valentine Leucocidin-Negative, Community-Acquired Methicillin-Resistant Staphylococcus aureus Bacteremia: An 11-Year Retrospective Study in Japan." Antibiotics 12, no. 10 (2023): 1516. http://dx.doi.org/10.3390/antibiotics12101516.

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Panton-Valentine leucocidin (PVL)-negative community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was originally disseminated in Japan and has since replaced healthcare-associated MRSA (HA-MRSA). However, the clinical characteristics of CA-MRSA bacteremia (CA-MRSAB) compared with those of HA-MRSA bacteremia (HA-MRSAB) are unknown. We aim to clarify differences and investigate associations between the clinical manifestations and virulence genes associated with plasma-biofilm formation in PVL-negative CA-MRSA. From 2011 to 2021, when CA-MRSA dramatically replaced HA-MRSA, 79 MRSA strains were collected from blood cultures and analyzed via SCCmec typing and targeted virulence gene (lukSF-PV, cna, and fnbB) detection. The incidence of metastatic infection was significantly higher in CA-MRSAB than in HA-MRSAB. PVL genes were all negative, although cna and fnbB were positive in 55.6% (20/36) and 50% (18/36) of CA-MRSA strains and 3.7% (1/27) and 7.4% (2/27) of HA-MRSA strains, respectively. cna and fnbB carriage were not associated with the development of metastatic infections in MRSAB; however, the bacteremia duration was significantly longer in CA-MRSAB harboring cna. CA-MRSAB may be more likely to cause metastatic infections than HA-MRSAB. Since CA-MRSA is dominant in Japan, suspected metastatic infection foci should be identified by computed tomography, magnetic resonance imaging, and echocardiography when treating MRSAB.

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Nimmo, Graeme R., Haakon Bergh, Jennifer Nakos, et al. "Replacement of healthcare-associated MRSA by community-associated MRSA in Queensland: Confirmation by genotyping." Journal of Infection 67, no. 5 (2013): 439–47. http://dx.doi.org/10.1016/j.jinf.2013.07.020.

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Park, Sun Hee, Chulmin Park, Jin-Hong Yoo, et al. "Emergence of Community-Associated Methicillin-ResistantStaphylococcus aureusStrains as a Cause of Healthcare-Associated Bloodstream Infections in Korea." Infection Control & Hospital Epidemiology 30, no. 2 (2009): 146–55. http://dx.doi.org/10.1086/593953.

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Background.The prevalence of community-associated methicillin-resistantStaphylococcus aureus(CA-MRSA) strains causing bloodstream infection (BSI) has not been studied in Korea.Objective.We sought to determine the prevalence of CA-MRSA strains among isolates recovered from patients with MRSA BSIs and to explore epidemiological changes in Korea. We also sought to evaluate clinical characteristics relevant to the development of healthcare-associated BSIs.Methods.We prospectively collected consecutive MRSA isolates from patients with BSI at 4 hospitals from July 1 through November 30, 2007, and we also included MRSA isolates recovered from culture of blood samples collected during a previous year (October 1, 2004 through September 30, 2005) at a different hospital. Molecular typing studies were performed, including pulsed-field gel electrophoresis (PFGE), multilocus sequence typing,Staphylococcusprotein A (spa) typing, and staphylococcal cassette chromosomemec(SCCmec) typing. We compared the clinical characteristics and outcomes of patients with healthcare-associated BSI due to CA-MRSA strains with those of patients with healthcare-associated BSI due to healthcare-associated MRSA (HA-MRSA) strains.Results.There were 76 cases of MRSA BSI, of which 4 (5.3%) were community-associated and 72 (94.7%) were healthcare-associated. Among the 72 HA-MRSA BSIs, 18 (25%) were community onset, and 54 (75%) were hospital onset. PFGE type D-ST72–spaB-SCCmectype IVA MRSA, the predominant genotype of CA-MRSA in Korea, accounted for 19 (25%) of all 76 MRSA BSIs, including 17 (23.6%) of 72 HA-MRSA BSIs and 11 (20.8%) of 53 hospital-onset HA-MRSA BSIs. Patients with healthcare-associated BSIs due to CA-MRSA strains carrying SCCmectype IVA tended to have fewer healthcare-associated risk factors, compared with patients with healthcare-associated BSIs due to HA-MRSA strains carrying other SCCmectypes. The presence of a central venous catheter or other invasive device was the only independent factor differentiating patients infected with hospital-associated genotype strains from patients infected with other strains. Clinical outcomes were similar between both groups.Conclusions.CA-MRSA strains are emerging as a major cause of BSI in healthcare settings in Korea. This changing epidemiology of MRSA poses a challenge to public health and infection control in hospital settings.

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Leman, Richard, Francisco Alvarado-Ramy, Sean Pocock, et al. "Nasal Carriage of Methicillin-ResistantStaphylococcus aureusin an American Indian Population." Infection Control & Hospital Epidemiology 25, no. 2 (2004): 121–25. http://dx.doi.org/10.1086/502361.

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AbstractBackground and Objective:Although reports of methicillin-resistantStaphylococcus aureus(MRSA) infections without healthcare exposure are increasing, population-based data regarding nasal colonization are lacking. We assessed the prevalence of and risk factors for community-associated MRSA nasal carriage in patients of a rural outpatient clinic.Design:A cross-sectional population survey was conducted through random sample and stratification by community of residence. Recent healthcare exposure (ie, hospitalization, dialysis, or healthcare occupation) and other risk factors for MRSA carriage were assessed. Cultures of the nares were performed. Community-associated MRSA was defined as MRSA carriage without healthcare exposure.Setting:A predominantly American Indian community in Washington.Patients:Those receiving healthcare from an Indian Health Service clinic.Results:Of 1,311 individuals identified for study, 475 (36%) participated. Unsatisfactory culture specimens resulted in exclusion of 6 participants. In all, 128 (27.3%) of 469 participants hadS. aureus.Nine (1.9%) of 469 had MRSA carriage; of these, 5 had community-associated MRSA (5 of 469; overall community-associated MRSA carriage rate, 1.1%). MRSA carriage was associated with antimicrobial use in the previous year (risk ratio [RR], 7.2;P= .04) and residence in a household of more than 7 individuals (RR, 4.5;P= .03). Pulsed-field gel electrophoresis indicated that 5 (55%) of 9 MRSA carriage isolates were closely related, including 3 (60%) of 5 that were community associated.Conclusions:Prevalence of community-associated MRSA colonization was approximately 1% in this rural, American Indian population. Community-associated MRSA colonization was associated with recent antimicrobial use and larger household.

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LLOYD-SMITH, E., M. W. HULL, M. W. TYNDALL, et al. "Community-associated methicillin-resistant Staphylococcus aureus is prevalent in wounds of community-based injection drug users." Epidemiology and Infection 138, no. 5 (2010): 713–20. http://dx.doi.org/10.1017/s0950268810000464.

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SUMMARYInjection drug users (IDUs) have an elevated risk for carriage of Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA). Cutaneous injection-related infections are common in IDUs but detailed studies are few. Based on a subsample of 218 individuals from a community-recruited cohort of IDUs at a supervised injection facility, we investigated the microbiology and related antibiotic susceptibility profiles of isolates from 59 wounds. Twenty-seven percent of subjects had at least one wound and 25 (43%) were culture positive for S. aureus alone [14 MRSA and 11 (19%) methicillin-susceptible (MSSA) isolates]. Sixteen of 18 MRSA isolates were classified as community associated (CA) by the presence of genes encoding for PVL. MRSA and MSSA occurred in mixed infection with other organisms on three and six occasions, respectively. All CA-MRSA isolates were susceptible to tetracycline, vancomycin and linezolid but only 13% were susceptible to clindamycin compared to 63% of MSSA isolates. The frequency of CA-MRSA is a cause for concern in wound infection in the IDU setting.

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EELLS, S. J., J. A. McKINNELL, A. A. WANG, et al. "A comparison of clinical outcomes between healthcare-associated infections due to community-associated methicillin-resistantStaphylococcus aureusstrains and healthcare-associated methicillin-resistantS. aureusstrains." Epidemiology and Infection 141, no. 10 (2012): 2140–48. http://dx.doi.org/10.1017/s0950268812002634.

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SUMMARYThere are limited data examining whether outcomes of methicillin-resistantStaphylococcus aureus(MRSA) healthcare-associated infections (HAIs) are worse when caused by community-associated (CA) strains compared to HA strains. We reviewed all patients’ charts at our institution from 1999 to 2009 that had MRSA first isolated only after 72 h of hospitalization (n = 724). Of these, 384 patients had a MRSA-HAI according to CDC criteria. Treatment failure was similar in those infected with a phenotypically CA-MRSA strain compared to a phenotypically HA-MRSA strain (23%vs. 15%,P = 0·10) as was 30-day mortality (16%vs. 19%,P = 0·57). Independent risk factors associated with (P < 0·05) treatment failure were higher Charlson Comorbidity Index, higher APACHE II score, and no anti-MRSA treatment. These factors were also associated with 30-day mortality, as were female gender, older age, MRSA bloodstream infection, MRSA pneumonia, and HIV. Our findings suggest that clinical and host factors, not MRSA strain type, predict treatment failure and death in hospitalized patients with MRSA-HAIs.

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Leonard, Steven N., Chrissy M. Cheung, and Michael J. Rybak. "Activities of Ceftobiprole, Linezolid, Vancomycin, and Daptomycin against Community-Associated and Hospital-Associated Methicillin-Resistant Staphylococcus aureus." Antimicrobial Agents and Chemotherapy 52, no. 8 (2008): 2974–76. http://dx.doi.org/10.1128/aac.00257-08.

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ABSTRACT We evaluated the activity of ceftobiprole against 100 community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) and 100 hospital-associated MRSA (HA-MRSA) isolates. Eight isolates were evaluated by time-kill studies for kill rate and potential for synergy with tobramycin. Ceftobiprole MIC50 and MIC90 values were 1 and 2 μg/ml, respectively, against CA-MRSA and HA-MRSA. In time-kill analysis, ceftobiprole was bactericidal at all concentrations tested.

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WIERSMA, P., M. TOBIN D'ANGELO, W. R. DALEY, et al. "Surveillance for severe community-associated methicillin-resistant Staphylococcus aureus infection." Epidemiology and Infection 137, no. 12 (2009): 1674–78. http://dx.doi.org/10.1017/s0950268809002490.

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SUMMARYCommunity-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has rapidly emerged in the USA as a cause of severe infections in previously healthy persons without traditional risk factors. We describe the epidemiology of severe CA-MRSA disease in the state of Georgia, USA and analyse the risk of death associated with three different clinical syndromes of CA-MRSA disease – pneumonia, invasive disease, and skin and soft-tissue infections (SSTIs). A total of 1670 cases of severe CA-MRSA disease were reported during 2005–2007. The case-fatality rate was 3·4%; sex and race of fatal and non-fatal cases did not differ significantly. While CA-MRSA pneumonia and invasive disease were less common than SSTIs, they were about 15 times more likely to result in death [risk ratio 16·69, 95% confidence interval (CI) 10·28–27·07 and 13·98, 95% CI 7·74–25·27, respectively]. When controlling for age and the presence of other clinical syndromes the odds of death in patients manifesting specific severe CA-MRSA syndromes was highest in those with pneumonia (odds ratio 11·34). Possible risk factors for severe CA-MRSA SSTI and pneumonia included the draining of lesions without medical assistance and an antecedent influenza-like illness.

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Frei, C. R., M. L. Miller, J. S. Lewis, et al. "Trimethoprim-Sulfamethoxazole or Clindamycin for Community-Associated MRSA (CA-MRSA) Skin Infections." Journal of the American Board of Family Medicine 23, no. 6 (2010): 714–19. http://dx.doi.org/10.3122/jabfm.2010.06.090270.

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Khardori, N. M. "Trimethoprim-Sulfamethoxazole or Clindamycin for Community-Associated MRSA (CA-MRSA) Skin Infections." Yearbook of Medicine 2011 (January 2011): 55–56. http://dx.doi.org/10.1016/j.ymed.2011.08.018.

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Davis, Meghan, Daniel Morris, Valerie Cluzet, et al. "Home Environmental Contamination Is Associated with Community-associated Methicillin-resistant Staphylococcus aureus Re-colonization in Treated Patients." Open Forum Infectious Diseases 4, suppl_1 (2017): S7. http://dx.doi.org/10.1093/ofid/ofx162.016.

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Abstract Background Strategies to interrupt household transmission of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) that target human colonization show mixed results. Our aim was to determine whether home environmental contamination and pet carriage with MRSA were associated with re-colonization or persistent colonization of index patients diagnosed with CA-MRSA skin or soft-tissue infection (SSTI). Methods Index patients from a randomized controlled trial (NCT00966446) that tested household-wide decolonization of people were eligible to participate in this substudy. Before randomization, eight environmental sites and all pets were sampled in the home. Patients were treated by their physician for the initial SSTI between diagnosis (visit 0) and the home visit (visit 1). They provided swabs every 2 weeks for 3 months (7 visits). After broth-enrichment culture, MRSA isolates were PCR-confirmed and spa-typed. Results Of 88 index patients recruited from the main trial, 64 (73%) provided swabs for ≥3 visits and were included in this analysis. At visit 1, 41 (64%) households were MRSA contaminated and 6 (9%) had MRSA-positive pet(s). All MRSA-positive pets lived in homes with MRSA environmental contamination. After visit 1, 42 (66%) index patients and their household members were block-randomized to nasal mupirocin and chlorhexidine body wash decolonization. Thirty-seven (58%) index patients had two consecutive negative swabs (de-colonized); 13 (35%) of these later were MRSA-positive (re-colonized). Patients with home contamination had higher rates of re-colonization than those without (Cox proportional hazard ratio 6.0 [95% CI: 1.2, 30.6], P &lt; 0.03). Persistent colonization (all or all but one swab positive) was identified in 6 (9%) of index patients and was associated with identification of matching spa-types in environmental and subsequent human MRSA isolates (P &lt; 0.05). Conclusion In patients with MRSA SSTI, MRSA-contaminated homes, and potentially MRSA-positive pets, are associated with re-colonization and persistent colonization. Future studies are needed to determine whether environmental decontamination can improve the success of household decolonization interventions. Disclosures All authors: No reported disclosures.

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Goldstein, Ellie J. C., Diane M. Citron, Yumi A. Warren, Kerin L. Tyrrell, and Michael J. Rybak. "Virulence characteristics of community-associated Staphylococcus aureus and in vitro activities of moxifloxacin alone and in combination against community-associated and healthcare-associated meticillin-resistant and -susceptible S. aureus." Journal of Medical Microbiology 57, no. 4 (2008): 452–56. http://dx.doi.org/10.1099/jmm.0.47580-0.

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The increasing prevalence of community-associated meticillin-resistant Staphylococcus aureus (CA-MRSA) poses a challenge for antimicrobial therapy of skin and soft tissue infections (SSTIs). To determine whether another antimicrobial agent might enhance the activity of moxifloxacin against CA-MRSA, this study analysed its activity alone and in chequerboard combination with doxycycline, rifampicin, clindamycin, trimethoprim, sulfamethoxazole/trimethoprim (SXT) and vancomycin against recent SSTI clinical isolates, and also characterized the isolates for Panton–Valentine leukocidin (PVL), agr groups, staphylococcal cassette chromosome mec (SSCmec) types and δ-haemolysin production. For comparison, 25 strains of outpatient meticillin-susceptible S. aureus (MSSA), 24 strains of healthcare-associated (HA)-MRSA and six historical strains of vancomycin-intermediate S. aureus (VISA) were included. It was found that 21/25 CA-MRSA strains tested were PVL-positive, SSCmec type 4 and agr type 1, whilst 4/25 were PVL-negative, SSCmec type 2 and agr type 2. Two of the agr type 2 strains were negative for δ-haemolysin but all other strains were positive. Moxifloxacin MIC50/90 values (μg ml−1) were 1/8 for CA-MRSA, 4/32 for HA-MRSA and ≤0.03/1 for MSSA and MIC50 of 2 for VISA. The D-test for inducible clindamycin resistance was positive for 3/27 CA-MRSA, 5/14 HA-MRSA and none of the MSSA isolates. In chequerboard studies, fractional inhibitory concentration indices (FICIs) showed that most interactions were additive or indifferent (FICI value >0.5 to ≤2) as follows: rifampicin 43/52 strains, clindamycin 44/44, SXT 44/47, trimethoprim 41/42 and vancomycin 37/43. The FICI values for doxycycline were 3–6 for 32/34 strains, indicating antagonism, suggesting that it should not be used in combination with moxifloxacin.

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SINGH, RANDHIR, SIMRANPREET KAUR, J. S. TOMAR, and J. P. S. GILL. "Methicillin resistant Staphylococcus aureus (MRSA) from community associated settings." Indian Journal of Animal Sciences 90, no. 3 (2020): 347–51. http://dx.doi.org/10.56093/ijans.v90i3.102321.

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Antibiotic resistance is a cause of concern worldwide. Community settings are important reservoir of drug resistant microorganisms like Staphylococcus aureus. The present study was to determine the prevalence, phenotypic and genotypic antibiotic resistance pattern of S. aureus isolated from different community settings of university campus. A total of 300 swab samples were collected for isolation of S. aureus from different community settings at university campus of Guru Angad Dev Veterinary and Animal Sciences University and Punjab Agriculture University, Ludhiana, India. Confirmed S. aureus isolates were further subjected to antibiotic sensitivity by Epsilometer test (E-test) and detection of antibiotic resistance genes. The prevalence of S. aureus in the community samples was 12% (36/300). Methicillin Resistant S. aureus (MRSA) contamination among community was 3.33% (10/300). Among S. aureus isolates from community samples 63.8% (23/36) and all the MRSA isolates were multidrug resistant (MDR). Five out of 10 MRSA carried SCCmec type IVa, and 4 were pvl positive gene, therefore, designated as community associated MRSA (CA-MRSA). Phenotypic resistance to antibiotics ciprofloxacin, chloramphenicol, ceftriaxone clindamycin and trimethoprim-sulfamethoxazole was 69.4% (MIC ≥32 μg/ml), 63.9% (MIC 32 μg/ ml), 16.7% (MIC 16–64 μg/ml), 16.7% (MIC 256 μg/ml) and 8.3% (MIC 12–64 μg/ml), respectively. Resistance genes blaZ, mecA, tetK, tetM, ermB and aacA-aphD were present. Presence of MRSA and MDR variant in community settings is a public health concern, as cell phone, offices telephone, computer keyboard and tap faucet are commonly shared or touched by people. Therefore, have potential to disseminate widely, not only in the community settings but also in hospitals environment, complicating treatment.

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Abdel-Maksoud, Mohamed, Mona El-Shokry, Ghada Ismail, et al. "Methicillin-Resistant Staphylococcus aureus Recovered from Healthcare- and Community-Associated Infections in Egypt." International Journal of Bacteriology 2016 (June 28, 2016): 1–5. http://dx.doi.org/10.1155/2016/5751785.

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Background. Methicillin-resistant Staphylococcus aureus (MRSA) has created significant epidemiological, infection-control, and therapeutic management challenges during the past three decades. Aim. To analyze the pattern of resistance of healthcare- and community-associated MRSA in Egypt and the trend of resistance of HA-MRSA over time (2005–2013). Methods. MRSA isolates were recovered from healthcare-associated (HA) and community-associated (CA) Staphylococcus aureus (S. aureus) infections. They were tested against 11 antimicrobial discs and the minimal inhibitory concentration (MIC) of vancomycin was determined. Inducible clindamycin resistance (iMLSB) was also screened using D-test. Findings. Of 631 S. aureus, MRSA was identified in 343 (76.6%) and 21 (11.5%) of HA and CA S. aureus isolates, respectively. The proportion of HA-MRSA increased significantly from 48.6% in 2005 to 86.8% in 2013 (p value < 0.001). Multidrug resistance (MDR) was observed in 85.8% of HA-MRSA and 48.6% of CA-MRSA. Vancomycin intermediate resistant S. aureus (VISA) was detected in 1.2% of HA-MRSA and none was detected in CA-MRSA. Among HA-MRSA strains, 5.3% showed iMLSB compared to 9.5% among CA-MRSA. Conclusion. The upsurge of the prevalence rates of HA-MRSA over time is alarming and urges for an effective infection control strategy and continuous monitoring of antimicrobial use.

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Popovich, Kyle J. "Intersection of HIV and community-associated methicillin-resistant Staphylococcus aureus." Future Virology 15, no. 1 (2020): 53–65. http://dx.doi.org/10.2217/fvl-2019-0093.

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The epidemiology of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has evolved over the past approximately 20 years, with certain populations appearing to have disproportionate risk. Of concern is the potential worsening of S. aureus infections in light of the continued opioid crisis. This review will discuss how CA-MRSA has significantly impacted HIV-infected individuals and address additional factors and populations that are associated with increased risk for MRSA. It will review therapeutic options and infection control strategies as well as highlight how whole genome sequencing can be used to extend traditional epidemiologic analysis and ultimately, inform infection prevention efforts. Continued work identifying those at the highest risk for MRSA, what the best infection prevention settings are in community settings and how to effectively implement and target these strategies is needed. Ultimately, infection control efforts will likely need to extend beyond healthcare settings to effectively and sustainably reduce MRSA infections.

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Dr., Mehul Shah, Hemraj Acharya Dr., Preeti Chhabria Dr., et al. "Community-Associated MRSA—Not So Innocent Sibling per Se: A Case Report." International Journal of Medical Science and Clinical Research Studies 04, no. 10 (2024): 1924–27. https://doi.org/10.5281/zenodo.14006816.

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Background: Methicillin-resistant S.aureus(MRSA) is a major healthcare burden and is classified as healthcare-associated (HA-MRSA) and community-associated (CA-MRSA). While HA-MRSA is clinically feared, CA-MRSA is often considered less pathogenic. This case report highlights the serious course of illness due to CA-MRSA infection and provides a treatment strategy for the management of such cases.Case description: A 41-year-old male presented with fever and breathlessness for five days. Upon admission, he was provided empirical treatment foratypical infections and vasopressor support for hypotension. His condition deteriorated, necessitating ventilator support. Although the initial tracheal Bio Fire test indicated MRSA, his clinical manifestations did not match MRSA pneumonia symptoms; however, CA-MRSA was confirmed within 12 h. Skin legions developed within 16 h and progressed gradually from ecchymosis, petechial, and palpable purpura to bullous lesions over 72 h. The antibiotic regimen was modified and optimized with the addition of Clindamycin, Vancomycin, and Meropenem–Colistin. Owing to high IL-6 levels, dual vasopressor support, and acute kidney failure, he was started on early (within 12 h) continuous renal replacement therapy (CRRT) with CytoSorb filter (for 3 days) for cytokine removal. IL-6 levels decreased after two days of CytoSorb use. Subsequently, the patient stabilized with reduced dependence on vasopressor and ventilator assistance.Discussion: Early diagnosis of CA-MRSA and management with CRRT using CytoSorb may help improve patient outcomes. To our knowledge, this is the first report of clinical management of CA-MRSA with CytoSorb therapy in India that resulted in positive outcomes.

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Pimentel, Jason D., Frederick A. Meier, and Linoj P. Samuel. "Chorioamnionitis and Neonatal Sepsis from Community-associated MRSA." Emerging Infectious Diseases 15, no. 12 (2009): 2069–71. http://dx.doi.org/10.3201/eid1512.090853.

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MALIK, S., P. VRANKEN, M. SILIO, R. RATARD, and R. VAN DYKE. "Prevalence of community-associated methicillin-resistantStaphylococcus aureuscolonization outside the healthcare environment." Epidemiology and Infection 137, no. 9 (2009): 1237–41. http://dx.doi.org/10.1017/s0950268809002222.

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SUMMARYCommunity-associated methicillin-resistantStaphylococcus aureus(CA-MRSA) infections are increasingly recognized in persons without established risk factors. Population-based prevalence studies of CA-MRSA colonization in persons without risk factors are relatively limited. Subjects aged 2–65 years were enrolled from a student recreation centre, public office building, and out-patient clinics. Persons or close contacts with a history of hospitalization, nursing-home residence, surgery, emergency-department visit, or healthcare employment during the previous year and persons with chronic debilitating illness, indwelling catheter, or surgical device were excluded. Swabs of anterior nares were obtained. Demographic and clinical information was collected. During January–June 2005, three (1·2%) of 259 subjects were colonized with MRSA. All three subjects were adults enrolled at the recreation centre. Healthy persons living in households without recent exposure to healthcare environments were at low risk for MRSA colonization. Studies from other geographic locations are needed to elucidate differences in prevalence of CA-MRSA.

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Menif, Khaled, Asma Bouziri, Ammar Khaldi, et al. "Community-associated methicillin-resistant Staphylococcus aureus infections in a pediatric intensive care unit." Journal of Infection in Developing Countries 5, no. 08 (2011): 587–91. http://dx.doi.org/10.3855/jidc.1565.

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Introduction: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection is an increasing problem worldwide. In developing countries, there is little data on CA-MRSA infection in children. This study reviewed the clinical features and outcomes of children admitted in a Tunisian pediatric intensive care unit with severe CA-MRSA infections. Methodology: Retrospective chart review of patients coded for CA-MRSA over 10 years. Results: There were 14 (0.32% of all admissions) patients identified with severe CA-MRSA infections. The median age was three months (range, 0.5-156 months). All patients had pulmonary involvement. Six children (42.8%) developed septic shock. Two (14.3%) patients had multifocal infection with deep venous thrombosis. Two (14.3%) patients died. Conclusions: Severe CA-MRSA pneumonia dominated presentation. The mortality of CA-MRSA infection in our series is lower than that previously reported.

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Khawcharoenporn, T. "Re: Trimethoprim-sulfamethoxazole or Clindamycin for Community-Associated MRSA (CA-MRSA) Skin Infections." Journal of the American Board of Family Medicine 24, no. 3 (2011): 331. http://dx.doi.org/10.3122/jabfm.2011.03.100305.

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Tsai, H. C., Y. S. Chen, S. S. J. Lee, and Y. C. Liu. "Comment on: Community-associated MRSA (CA-MRSA): an emerging pathogen in infective endocarditis." Journal of Antimicrobial Chemotherapy 61, no. 4 (2008): 966–67. http://dx.doi.org/10.1093/jac/dkn061.

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