Epidemiology of community-acquired meticillinresistant Staphylococcus aureus obtained from the UK West Midlands region.

Between January and December 2005, 199 MRSA isolates were obtained from nonhospitalised patients presenting skin and soft tissue infections to local GPs. The study area incorporated 57 surgeries from three Primary Care Trusts in the 4 regions of Central England, UK. Following antibiotic susceptibility testing, pulsed-field gel electrophoresis, PantoneValentine leukocidin gene detection and SCCmec element assignment, 95% of the isolates were shown to be related to hospital epidemic strains EMRSA-15 and EMRSA-16. In total 87% of the isolate population harboured SCCmec IV, 9% had SCCmec II and 4% were identified as carrying novel SCCmec IIIa-mecI. When mapped to patient home postcode, a diverse distribution of isolates harbouring SCCmec II and SCCmec IV was observed; however, the majority of isolates harbouring SCCmec IIIa-mecI were from patients residing in the north-west of the study region, highlighting a possible localised clonal group. Transmission of MRSA from the hospital setting into the surrounding community population warrants the need for targeted patient screening and decolonisation in both the clinical and community environments. Journal of Hospital Infection. 2008;70:314-20.