Objectives
Methicillin-resistant Staphylococcus aureus (MRSA), originally restricted to hospitals, has emerged as a significant pathogen in the community. Although MRSA accounts for over 60% of S . aureus in tertiary hospitals in Korea, little is known about the epidemiology of community-associated MRSA (CA-MRSA).

Methods
From January to July 2005, a hospital laboratory-based survey was conducted in seven community-based or tertiary hospitals. The medical records and Health Insurance Review Agency databases were reviewed and MRSA isolated from patients without apparent risk factors was defined as CA-MRSA. Susceptibilities to 12 antibiotics were tested by the disc diffusion method. SCC mec typing, Panton–Valentine leucocidin (PVL) gene detection and multilocus sequence typing (MLST) were performed according to published protocols.

Results
Of 3251 S . aureus , 1900 (58.4%) were MRSA. CA-MRSA accounted for 112 (5.9%) of the MRSA. Of the 112 CA-MRSA isolates, 27 and 33 were found to be pathogens and colonizers, respectively. Fifty-two isolates from the patients with chronic otitis media were classified as ‘undetermined’. Most of the 27 CA-MRSA patients had skin and soft tissue infections or acute ear infections. None of the patients died during the study period. Among 72 isolates tested, 64% were multidrug-resistant. SCC mec type IVa was the most common type among the colonizers and pathogens. On MLST analysis, ST₇₂ was predominant, but ST₅ and ST₂₃₉ were prevalent in the ‘undetermined’ group. None possessed the PVL gene.

Conclusions
Despite MRSA-endemic hospital settings, CA-MRSA infections are not common in Korea. A new clone of CA-MRSA, ST₇₂-SCC mec type IVa without the PVL gene, is the most common form.