Increasing threat of community-acquired methicillin-resistant Staphylococcus aureus

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a serious problem in the community. The objective of this prospective study was to report the frequency of community-acquired MRSA (CA-MRSA) isolates at King Fahd Hospital of the University in the Eastern Province of Saudi Arabia, to describe the spectrum of disease observed in patients infected with CA-MRSA and to study the antibiotic susceptibility profile.

Isolates of CA-MRSA from King Fahd Hospital of the University were reviewed prospectively during an 8-year period, from January 2001 to December 2008.

The prevalence of CA-MRSA infections increased from 9.9 per 10,000 admissions in 2001 to 67 per 10,000 admissions in 2008 (P < 0.001). The number of CA-MRSA increased from 67 isolates in the first part of the study (2001-2004) to 176 cases in the second period of the study (2005-2008), and the percentage of CA-MRSA/of the total MRSA isolates rose from 20% in the first period to 59% in the second period of the study (P < 0.001). Soft tissue infections accounted for 198 (81%) of the 243 cases of CA-MRSA infections and invasive infections in 14 (7%) patients. The antibiotic susceptibility pattern has also changed with increasing levels of resistance to erythromycin, tetracycline, clindamycin, ciprofloxacin and gentamicin.

Continued emergence of MRSA in the community is a public-health problem that demands increased vigilance in the diagnosis and management of suspected and confirmed staphylococcal infections.