We describe an investigation of soft-tissue infections caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) strains in 2 healthcare workers employed in an outpatient clinic for patients with human immunodeficiency virus infection. Cultures of environmental samples from multiple surfaces in the clinic grew toxin-producing CA-MRSA strains, suggesting fomites may play a role in the transmission of these strains of MRSA.

During 1999-2003 in a Saudi Arabian Hospital, methicillin-resistant Staphylococcus aureus constituted 6% of all S. aureus isolates; the proportion had increased from 2% in 1999, to 9.7% in 2002, to 8% in 2003. Of all MRSA isolates, 62% represented community-acquired infection, 20.4% represented healthcare-associated infection, and 17.6% represented nosocomial infection. The proportion of community-acquired isolates increased from 41.7% in 1999 to 66.6% in 2002, and the proportion representing nosocomial infection decreased from 33% in 1999 to 19% in 2003. Isolates representing nosocomial infection showed higher rates of resistance to ciprofloxacin (76.6%), clindamycin (76.6%), erythromycin (68%) and trimethoprim-sulfamethoxazole (68%) than did isolates in the other categories (P<.001).