1. Hospital-acquired and community-acquired MRSA in hospitals.

2. Hospital-acquired methicillin resistant s.aureus
High percentage of hospital S.aureus isolates has been found to be also resistant to methicillin or oxacillin.
Antibiotic resistant is caused by chromosomal acquisition of the gene for a modified penicillin-binding protein.This protein codes for a new peptidoglycan transpeptidase with a low affinity for all currently available beta-lactam antibiotics,and thus renders infections with methicillin-resistant S.aureus unresponsive to beta-lactam therapy.

3. Community –acquired methicillin –ristant S.aureus:
MRSA emerged in the community setting occurring among young healthy individuals with no exposure to the healthcare setting.since then this CA-MRSA has rapidly spread throughout the world.Outbreaks of CA-MRSA have been reported among children,athletes,nurseries and obstertical wards.

4. The patients in the hospital are divided into five compartments:.
The patients in the hospital are divided into five compartments:
-number of susceptible patients.
-number of patients colonized with the CA- MRSA strain.
-number of patients colonized with the HA- MRSA strain.
-number of patients infected with the CA-MRSA strain
-number of patients infected with the HA-MRSA strain.

5. Estimated methicillin-resistant S
Estimated methicillin-resistant S.aureus MRSA-related hospitalization rates during 7 years

6. Pediatric pneumonia caused by CA-MRSA
CA-MRSA, which carries genes for Panton-Valentine leukocidin (PVL), has become a major concern worldwide. CA-MRSA is mainly associated with skin and soft tissue infections in young, otherwise healthy, persons in the community and also with life-threatening sepsis and community-acquired pneumonia (preceded by influenza). PVL, in combination with staphylococcal protein A, destroys respiratory tissue and bacteria-engulfing immune cells.
(6)

7. .
Necrotizing Fasciitis is a life-threatening infection of the superficial muscle fascia and adjacent subcutaneous tissue. staphylococcus aurous has been occasionally reported as a monomicrobial causative agent of necrotizing fasciitis and methicillin-resistant staphylococcus aureus was described as the cause of hospital-associated necrotizing.

8. .
Necrotizing fasciitis of the back caused by MRSA The lower back showed erythematous lesions with skin necrosis.

9. .
Some studies suggest that CA-MRSA will become the dominant MRSA strain in the hospital setting and other studies shown that when no colonized or infected patients enter the hospital, competitive exclusion of HA-MRSA by CA-MRSA will occur with increased severity of CA-MRSA infections resulting in longer hospitalizations and a larger in-hospital reservoir of CA-MRSA. Improving compliance with hand hygiene and decolonization of CA-MRSA carriers are effective control strategies..

10. . .
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