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  lüll Community-acquired methicillin-resistant Staphylococcus aureus: what do we need  to know?Witte WClin Microbiol Infect  2009[Dec]; 15 Suppl 7 (ä): 17-25Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has  become a matter of concern worldwide, in particular in the USA. For the analysis  of emergence and spread, clear definitions based on epidemiological origin are  needed for discrimination between CA-MRSA, healthcare-associated community MRSA,  and healthcare-associated MRSA (HA-MRSA). Although its role in pathogenesis is  currently under debate, the capability for Panton-Valentine leukocidin formation  is associated with the majority of CA-MRSA isolates from North America and from  Europe. Most CA-MRSA isolates are attributed to clonal lineages different from  HA-MRSA; there are, however, clonal lineages from which both HA-MRSA and CA-MRSA  have been reported (e.g. ST1, ST5, ST8, and ST22); CA-MRSA ST8 (USA300), which is  most frequent in the USA, has meanwhile been reported from Europe. CA-MRSA ST80  is widely disseminated in Europe; because of its pronounced oxacillin  heteroresistance phenotype, cefoxitin-based assays are advisable for reliable  detection. So far, CA-MRSA infections seem to be much less frequent in Europe  than in the USA, where patients with particular predispositions and low social  status are at especial risk.|Bacterial Toxins/biosynthesis[MESH]|Bacterial Typing Techniques[MESH]|Community-Acquired Infections/*epidemiology/*microbiology[MESH]|Cross Infection/epidemiology/microbiology[MESH]|DNA Fingerprinting[MESH]|Europe/epidemiology[MESH]|Exotoxins/biosynthesis[MESH]|Genotype[MESH]|Humans[MESH]|Leukocidins/biosynthesis[MESH]|Methicillin-Resistant Staphylococcus aureus/classification/*isolation &  purification/*pathogenicity[MESH]|Microbial Sensitivity Tests/methods[MESH]|North America/epidemiology[MESH]|Risk Factors[MESH]|Staphylococcal Infections/*epidemiology/*microbiology[MESH]|Virulence Factors/biosynthesis[MESH]|beta-Lactams/pharmacology[MESH] |