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Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) which is the most common cause of skin and soft tissue infections and necrotizing pneumonia can also lead to many clinical condition. Trauma causing disruption of skin barrier integrity, intravenous drug use, living in crowded environments such as prison/dormitory/nursing home, low socioeconomic status, nasal S. aureus carriage, presence of health workers in the family, history of hospital admission and recent use of antibiotics are the most important risk factors. Panton-Valentine leukocidin is a cytotoxin which is found especially in the CA-MRSA strains. The infection is aggravated by Panton-Valentine leukocidin (PVL) which causes lytic pores in leukocytes. Strains which contain PVL are found to be associated with tissue necrosis and abscess formation. CA-MRSA strains contain staphylococcal chromosomal cassette (SCC)mec type IV or V gene cassette, so resistance is seen only against β-lactam group antibiotics. In this report, we present two cases of severe skin and soft tissue infections caused by CA-MRSA. Both patients who had risk factors for CA-MRSA underwent surgical drainage and debridement. Methicillin-resistant S. aureus strains isolated from the patients were positive for SCCmec type IV and PVL. In general, β-lactam antibiotics are preferred in the treatment of community-acquired skin and soft tissue infections. Because of the increasing in CA-MRSA incidence, the risk factors for CA-MRSA should be evaluated in patients and the empirical treatment should be planned accordingly.
Klimik Dergisi 2020; 33(2): 180-4.
Cite this article as: Emre A, Seyman D, Merve Türker M, et al. [Cases with skin and soft tissue infections caused by community-acquired methicillin-resistant Staphylococcus aureus]. Klimik Derg. 2020; 33(2): 180-4. Turkish.