Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is emerging as a cause of skin and soft-tissue infections in persons who have little or no contact with health-care settings. The majority of these infections are mild, involving skin and soft tissue; however, certain cases can progress to invasive tissue infections, bacteremia, and death. Transmission of MRSA has been reported most frequently in certain populations (e.g., children, sports participants, or jail inmates). Persons in the American Indian or Alaska Native population in the United States and aboriginals and Pacific Islanders (PIs) in Australia have high rates of MRSA colonization and infection. In 2003, clinicians reported an increased number of skin abscesses caused by MRSA among patients examined in ambulatory care settings. This report summarizes the findings of a retrospective study of community-associated MRSA (CA-MRSA) infections in Hawaii that identified a higher proportion of cases among PIs than were identified among Asians, compared with their respective proportions in the Hawaii population. Efforts to prevent CA-MRSA in Hawaii should focus on identifying factors causing the disproportionate number of infections among PIs.