Invasive community-associated MRSA infections: epidemiology and antimicrobial management

Importance of the field: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is now a predominant cause of infections in the community and is adding to the overwhelming MRSA burden in the hospital setting. CA-MRSA is most commonly noted as a prominent pathogen in skin and soft tissue infections (SSTI) but has been increasingly described in more invasive disease. New developments in the epidemiology and treatment of CA-MRSA have emerged to improve the understanding of this disease. Areas covered in this review: We present the latest epidemiologic and clinical treatment studies of CA-MRSA in a variety of infection types. The methods used involve a comprehensive literature search of the previous 10 years, including a detailed focus on new literature in the last 5 years. The search terms used were 'CA-MRSA epidemiology', 'S. aureus resistance', 'CA-MRSA treatment', and 'S. aureus virulence'. What the reader will gain: An in-depth understanding of the changing epidemiology of CA-MRSA and management of SSTI and more invasive infections with this pathogen. Adjunctive and alternative therapies are also reviewed. Take home message: The epidemiology of CA-MRSA is rapidly evolving. Increasing multi-drug resistance along with virulence factors associated with this serious disease complicate its treatment. Additional clinical trials are needed to select optimal regimens in the treatment of invasive CA-MRSA infections.