Management of cutaneous lesions associated with an emerging epidemic: community-acquired methicillin-resistant Staphylococcus aureus skin infections

Abstract

C ommunity-acquired methicillin-resistant Staphylococcus aureus (CAMRSA) infections are increasing as a clinical problem. The most common manifestations are skin and soft tissue infections. In contrast to nosocomial-acquired methicillin-resistant S aureus (MRSA) infections, CAMRSA infections: (1) often occur in individuals who are immunocompetent without MRSA-associated risk factors; (2) tend to be susceptible to most non-beta-lactam antibiotics; (3) can be virulent and fatal; and (4) have a type IV staphylococcal cassette chromosome (SCCmec) genetic element (which carries mecA, the methicillin resistance gene) that is distinct from types I, II, and III SCCmec elements that are associated with hospital-acquired MRSA infections.* In the United States, outbreaks of cutaneous CAMRSA infections have been reported in cities from several states: the southwestern region of Alaska; Los Angeles, Calif; Honolulu, Hawaii; Chicago, Ill; Louisville, Ky; the Minneapolis-St Paul metropolitan area of Minnesota; Mississippi; the southeastern New England area of Rhode Island; Corpus Christi and Houston, Tex; and the southern region of Vermont. CAMRSA skin infection is also being reported throughout the world: Australia; Canada; China; Finland; France; Greece; Hong Kong; Israel; Italy; Japan; New Zealand; Portugal; Saudi Arabia; Singapore;