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To the Editor: In their study of laboratory isolates, Dr Naimi and colleagues¹ found that community-acquired methicillin-resistant Staphylococcus aureus (MRSA) had different clinical, demographic, and microbiological characteristics than health care–associated MRSA. The authors acknowledged that their study was not population-based. Many studies on this topic have not been population-based and the majority have not tried to measure community-associated MRSA prevalence.² Some have suggested that control of health care–associated MRSA, which Naimi et al found to account for a large majority of MRSA isolates in Minnesota, may be more difficult if MRSA becomes widespread in the community.³ Prevalence studies, preferably population-based, are needed to determine how widespread MRSA is in communities and nations. Available prevalence studies suggest that MRSA is not yet widespread in the United States or Europe.² In a population-based study of a Native American population, focusing on a significant increase in community MRSA infections in which MRSA was . . . [Full Text of this Article]

Cassandra D. Salgado, MD, MS
salgadoc@mail.ecu.edu
Brody School of Medicine
East Carolina University
Greenville, NC

Barry M. Farr, MD, MSc
University of Virginia Health System
Charlottesville