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JAC Advance Access published online on October 25, 2007

Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkm410
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Leading article

Community-associated MRSA (CA-MRSA): an emerging pathogen in infective endocarditis

B. Cherie Millar1, Bernard D. Prendergast2 and John E. Moore1,*

1 Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Lisburn Road, Belfast BT9 7AD, Northern Ireland, UK 2 Department of Cardiology, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK


* Corresponding author. Tel: +44-28-9026-3554; Fax: +44-28-9026-3991; E-mail: jemoore{at}niphl.dnet.co.uk

Over the last decade, a novel methicillin-resistant Staphylococcus aureus (MRSA) has emerged, primarily associated with healthy individuals within the community. This organism is distinct from healthcare-associated MRSA (HA-MRSA) in terms of epidemiology, microbiology and clinical manifestation and as such has been defined as community-associated MRSA (CA-MRSA). Given that S. aureus is a major aetiological agent of infective endocarditis (IE), particularly associated with the iv drug user population, reports of IE attributed to CA-MRSA are now emerging in the literature. The aims of this article are to (i) define and contrast CA-MRSA with HA-MRSA; (ii) review the published cases of CA-MRSA IE to date; and (iii) evaluate the current international recommendations for antibiotic prophylaxis and treatment regimens for IE in relation to CA-MRSA.

Key Words: community-acquired MRSA , PVL , Panton-Valentine leucocidin


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