TY - JOUR T1 - MRSA as a cause of community-acquired pneumonia JF - European Respiratory Journal JO - Eur Respir J SP - 1013 LP - 1014 DO - 10.1183/09031936.00120009 VL - 34 IS - 5 AU - A. Nakou AU - M. Woodhead AU - A. Torres Y1 - 2009/11/01 UR - http://erj.ersjournals.com/content/34/5/1013.abstract N2 - Staphylococcus aureus is a species of bacterium that can cause a broad variety of infections, ranging from minor skin infections to severe pneumonia and sepsis. The genetic adaptation of S. aureus has led to a multidrug-resistant pathogen, meticillin-resistant S. aureus (MRSA) after the introduction of meticillin (previously methicillin) into clinical practice in the 1960s 1. MRSA is resistant to β-lactam antibiotics, including penicillin and cephalosporins. Resistance is mediated by penicillin binding protein 2a, a penicillin binding protein encoded by the mecA gene that permits growth in the presence of meticillin. The mecA gene is situated in the staphylococcal cassette chromosome SCCmec. Initially, MRSA was only a nosocomial pathogen, i.e. healthcare-associated MRSA. It is associated with severe invasive disease 2 and tends to have multidrug resistance. It carries SCC chromosome type II (SCCmec type II) 3. In the mid 1990s, MRSA began to be detected in the community, i.e. community-acquired MRSA (CA-MRSA). It is the leading cause of identifiable skin and soft tissue infections seen in USA emergency rooms 4. CA-MRSA (and meticillin-susceptible S. aureus (MSSA)) may be associated with the presence of Panton Valentine leukocidin (PVL), a two-component staphylococcal membrane toxin that targets leucocytes 5 and frequently carries SCC mec type V or IV. PVL isolates have been linked to severe infections and necrotising pneumonia 6. Published data has suggested that MRSA was not a frequent cause of community-acquired pneumonia (CAP), although … ER -