{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:00:01Z","timestamp":1790910001421,"version":"4.1.0"},"reference-count":0,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2000,1,1]],"date-time":"2000-01-01T00:00:00Z","timestamp":946684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Canadian Journal of Infectious Diseases and Medical Microbiology"],"published-print":{"date-parts":[[2000,1]]},"abstract":"OBJECTIVES: To discuss the historical epidemiology of methicillin\u2010resistant Staphylococcus aureus<\/jats:italic> (MRSA) and review the literature suggesting that MRSA has become a community pathogen.<\/jats:p>DATA SOURCES: A search of the MEDLINE database was performed, encompassing all English or French language citations \u00a0from 1966 to 1999 and containing the subjects and\/or text words: \u2032Staphylococcus aureus\u2032<\/jats:italic>, \u2032methicillin resistance\u2032, \u2032endocarditis\u2032, \u2032cellulites\u2032, \u2032pneumonia\u2032 and \u2032community\u2010acquired\u2032. Articles published in other languages that provided English or French abstracts were included. All relevant references cited in articles obtained from the MEDLINE database and book chapters were also included.<\/jats:p>DATA EXTRACTION: All articles obtained from the above sources were examined and were included in the review if a laboratory or epidemiological study of community\u2010acquired MRSA was presented.<\/jats:p>DATA SYNTHESIS AND CONCLUSIONS: MRSA has emerged over the past 30 years to become a worldwide nosocomial pathogen and has recently been reported as a cause of community\u2010acquired infections. The changing epidemiology of MRSA is likely because of two mechanisms: the movement of nosocomial MRSA strains into the community and the de novo appearance of community strains resulting from the transfer of genetic material from methicillin\u2010resistant Gram\u2010positive organisms to sensitive S aureus<\/jats:italic> strains. The emergence of MRSA as a community pathogen has occurred at a slower rate than it did for penicillin\u2010resistant S aureus<\/jats:italic> (PRSA) in the 1950s and 1960s, possibly because the mechanism of methicillin resistance does not exhibit the same ease of transferability as that of penicillin resistance. Four case reports, seven case series, 10 case\u2010control studies and two cohort studies on community\u2010acquired MRSA were analyzed. Determining whether these reports involve new community\u2010acquired strains rather than previously acquired nosocomial strains can be problematic. It appears, however, that MRSA strains of both nosocomial and community origin are now endemic in certain communities in different parts of the world. Few surveillance studies of nonhospitalized patient populations have been performed to date; thus, the true prevalence of MRSA in the community at large is essentially unknown, although it appears to be low. At present, the empirical treatment of community\u2010acquired S aureus<\/jats:italic> infections with a beta\u2010lactamase\u2010stable beta\u2010lactam antibiotic is appropriate for most populations. However, empirical vancomycin therapy for serious S aureus<\/jats:italic> infections should be strongly considered for patients with significant risk factors for previously\u2010acquired nosocomial MRSA or for patients belonging to outpatient populations with a proven high prevalence of MRSA. Increasing vancomycin use will likely have a significant impact on the development of resistance in Gram\u2010positive organisms.<\/jats:p>","DOI":"10.1155\/2000\/424359","type":"journal-article","created":{"date-parts":[[2016,3,15]],"date-time":"2016-03-15T07:56:37Z","timestamp":1458028597000},"page":"202-211","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Is Methicillin\u2010Resistant Staphylococcus aureus<\/i> an Emerging Community Pathogen? A Review of the Literature"],"prefix":"10.1155","volume":"11","author":[{"given":"Michael A","family":"Gardam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2000,8]]},"container-title":["Canadian Journal of Infectious Diseases and Medical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cjidmm\/2000\/424359.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/2000\/424359","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T15:30:45Z","timestamp":1722353445000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/2000\/424359"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,1]]},"references-count":0,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2000,1]]}},"alternative-id":["10.1155\/2000\/424359"],"URL":"https:\/\/doi.org\/10.1155\/2000\/424359","archive":["Portico"],"relation":{},"ISSN":["1712-9532","1918-1493"],"issn-type":[{"value":"1712-9532","type":"print"},{"value":"1918-1493","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,1]]},"assertion":[{"value":"2000-08-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}