Community-acquired Staphylococcus aureus, a recent problem.

“Community-acquired Staphylococcus aureus bacteremia in children: A cohort study for 2010-2014” (page 508) describes the circulation of resistant microorganisms, in this case, Staphylococcus aureus. The study was very well designed, inclusion criteria were adequate, and the follow-up period was sufficient. It complied with its objectives: to describe antibiotic resistance observed in bacteremias, and to compare the characteristics of such bacteremias in terms of methicillin resistance.1 It is very important to have local, updated data available like those provided by this prospective study with results reported for a 5-year period. Staphylococcus aureus (SA) is widely spread in the nature and is capable of colonizing humans and fomites very frequently. Around 30% of the population is colonized by SA, and this percentage increases to 60% among health care providers. Colonization may last weeks or months.2,3 At present, it is a major health problem, at both the hospital and the community levels. It is very common to find SA in intensive care, neonatology, and surgery units. Cases may be isolated or occur as part of an outbreak, and affect children of any age. During adolescence, SA is the most common causative agent of communityacquired sepsis,3-5 probably due to transmission in dressing rooms used in relation to sport activities. In recent years, the number of cases has increased, and antibiotic resistance has become more marked. More than 50 years ago, Patricia Jevons published the first descriptions of methicillinresistant Staphylococcus aureus (MRSA). Most cases were related to the hospital setting, and their rate increased notably in the 1990s. Emergence and dissemination reached the community in the form of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA); its resistance pattern specifically affected children with no underlying conditions or hospitalization history. The first reports of CA-MRSA isolation were mostly related to skin and soft tissue infections (80-85%). Surveillance studies found that 7-10% of cases occurred as an invasive infection, e.g. pyomyositis, osteomyelitis, septic arthritis, or endocarditis, and as severe conditions, such as necrotizing Community-acquired Staphylococcus aureus, a recent problem