title: Community-associated methicillin-resistant Staphylococcus aureus infections in Israel.
abstract: BACKGROUND
  Community-associated methicillin-resistant Staphylococcus aureus infections are increasingly being documented worldwide. In Israel, however, CA-MRSA infections have not yet been reported, so awareness among physicians may be low.
  
  
  OBJECTIVE
  To alert physicians to the possibility of CA-MRSA infection, which necessitates a distinct therapeutic approach.
  
  
  METHODS
  We present three children with soft tissue infections caused by CA-MRSA who were treated in our medical center from January to March 2009.
  
  
  RESULTS
  In all three cases CA-MRSA was identified as the causative pathogen after surgical or spontaneous drainage. On susceptibility testing, the organisms were resistant to beta-lactam antibiotics but susceptible to clindamycin, rifampicin and trimethoprim-sulfamethoxazole.
  
  
  CONCLUSIONS
  Physicians should maintain an index of suspicion for CA-MRSA infections. The antibiotic-resistance profile of S. aureus should be watched carefully, and in particular, cultures should be obtained whenever soft tissue infections fail to respond to conventional treatment.
authors.affiliation: Department of Pediatrics A, Schneider Children's Medical Center Petah Tikva, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors.forename: Alon
authors.initials: A
authors.lastname: Nevet
authors.forename: Shai
authors.initials: S
authors.lastname: Ashkenazi
authors.forename: Zmira
authors.initials: Z
authors.lastname: Samra
authors.forename: Gilat
authors.initials: G
authors.lastname: Livni
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002675:Child, Preschool; D002981:Clindamycin / Q000494:pharmacology; D017714:Community-Acquired Infections / Q000453:epidemiology*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D012293:Rifampin / Q000494:pharmacology; D018461:Soft Tissue Infections / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013413:Sulfadoxine / Q000494:pharmacology; D014295:Trimethoprim / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; C000301:trimethoprim, sulfadoxine drug combination; D002981:Clindamycin; D013413:Sulfadoxine; D014295:Trimethoprim; D012293:Rifampin