title: Community-associated methicillin-resistant Staphylococcus aureus skin infections: advances toward identifying the key virulence factors.
abstract: OBJECTIVE
  In recent years there has been an increase in the incidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in healthy individuals, the cause of which is largely unknown. CA-MRSA primarily causes skin and soft-tissue infections but certain strains are also associated with unusually severe pathology. The purpose of this review is to provide a critical analysis of our current knowledge of virulence factors contributing to skin and soft-tissue infections caused by CA-MRSA.
  
  
  RESULTS
  Isolates classified as pulsed-field gel electrophoresis type USA300 have emerged as the predominant CA-MRSA genotype and in most geographic areas account for 97% or more of CA-MRSA infections. Recent key studies, such as those reporting the complete genome sequence of USA300, and the discovery of cytolytic peptides that contribute significantly to CA-MRSA virulence, lead the way for future investigations.
  
  
  CONCLUSIONS
  Although we have only a cursory understanding of the molecular mechanisms of CA-MRSA virulence, studies using clinically relevant CA-MRSA isolates are beginning to identify virulence determinants specific to this pathogen. Identifying CA-MRSA virulence determinants and the concerted regulation of these factors will foster development of vaccines and therapeutics designed to control CA-MRSA skin infections.
authors.affiliation: Department of Veterinary Molecular Biology, Montana State University, Bozeman, MT 59718, USA.
authors.forename: Tyler K
authors.initials: TK
authors.lastname: Nygaard
authors.forename: Frank R
authors.initials: FR
authors.lastname: DeLeo
authors.forename: Jovanka M
authors.initials: JM
authors.lastname: Voyich
mesh_terms: D017714:Community-Acquired Infections / Q000382:microbiology; D006801:Humans; D007956:Leukocidins / Q000235:genetics; D016106:Methicillin Resistance; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000235:genetics / Q000276:immunology / Q000472:pathogenicity; D014774:Virulence / Q000502:physiology; D037521:Virulence Factors / Q000235:genetics*
chemical_list: D007956:Leukocidins; D037521:Virulence Factors