Community-acquired methicillin resistant Staphylococcus aureus skin infection.

Staphylococcus aureus is one of the most common pathogens in skin and soft tissue infections, as well as in potentially serious nosocomial infections in patients who acquire it when hospitalized. Penicillin was introduced in the 1940's as an effective treatment against S. aureus. However, shortly after penicillin's introduction, penicillin resistance to S. aureus emerged due to a plasmid-mediated beta-lactamase enzyme. In 1959, a semisynthetic penicillin, methicillin was introduced to overcome the resistance problem. However, within a year, bacteria resistant to methicillin and other penicillinase stable beta-lactams, were present. Worldwide emergence of methicillin-resistant S aureus (MRSA) was established by the 1980's. Since that time, MRSA has become widespread in hospitals and long-term care facilities around the world, accounting for numerous nosocomial infections. Recently, there has been an alarming increase in the incidence of community-acquired MRSA (CA-MRSA). Patients with CA-MRSA began to be reported in the early 1990's and its prevalence has continued to increase. This paper summarizes the current information known about CA-MRSA as it relates to skin infections including populations at risk, clinical presentation, and treatment options.