Emergence of methicillin-resistant Staphylococcus aureus as a community pathogen.

Methicillin-Resistant Staphylococcus aureus (MRSA) infection is an established nosocomial pathogen, with hospital-based outbreaks occurring worldwide. An increase in MRSA infections without risk factors has been recently documented in several reports. A prospective study was conducted over a 36-month period to determine the prevalence and risk factors for community-acquired MRSA infection at King Fahad Hospital of the University Al-Khobar, Saudi Arabia. Patients hospitalized within the previous 12 months or transfers from hospitals or nursing homes were excluded. The number of patients with community-acquired MRSA disease increased from a single patient in 1998 to fifteen patients in the year 2000 and the percentage of community-acquired MRSA/total number of MRSA increased from 5% to 33%. Fifteen (75%) of 20 patients with community-acquired MRSA infection had no discernible characteristics of MRSA infections. Skin and soft tissue infections were the predominant presentation. Most MRSA isolates (95%) were susceptible to multiple antibiotics. Our data suggest that MRSA is an emerging community pathogen. Hospital infection control strategies will have to be redefined and community approaches developed to reduce transmission.