In the present study, several conventional methods to detect methicillin-resistant Staphylococcus aureus (MRSA) were compared with polymerase chain reaction (PCR) detection of mecA gene-positive isolates. Cefoxitin E-test was also evaluated as a possible phenotypic method of MRSA detection. Oxacillin agar screen and PBP2' latex agglutination methods were found to be more sensitive than oxacillin and cefoxitin disk-diffusion methods. Cefoxitin disk diffusion was found to be the most specific. A combination of oxacillin agar screening with cefoxitin disk diffusion, or oxacillin disk diffusion with PBP2', improved sensitivity and specificity. Cefoxitin E-test with the current break points had low sensitivity and specificity (33.3% and 75%, respectively) for the detection of MRSA. However, changing the break points to or= 6 microg/ml for sensitive and resistant, respectively, greatly improved both. Changing the 30-microg cefoxitin disk-diffusion break points to

Background: Methicillin-resistant Staphylococcus aureus (MRSA), is associated with high morbidity and mortality rates with rapid development of resistance.

Objectives: To evaluate the effectiveness of topical eutectic mixture of local anaesthetics (EMLA Õ ) cream in reducing the pain associated with vaccination injections. Methods: This was a randomized, double-blind, placebo-controlled study that included children who presented for routine immunization. Eligible children were randomly assigned to receive either EMLA Õ or placebo cream. The Modified Behavioural Pain Scale (MBPS) was used to assess baseline and postvaccination pain scores, while a visual analogue scale (VAS) was used to assess pain at the time of the needle prick and at the end of the injection. Results: A total of 107 children were enrolled in the EMLA Õ group and 109 children in the placebo group. The difference between the pre-and postvaccination MBPS scores was significantly lower in the EMLA group than in the placebo group (2.56 AE 1.96 versus 3.95 AE 2.20, respectively). The VAS scores at the time of the needle prick and after the injection were significantly lower in the EMLA Õ group compared with the placebo group (1.60 AE 1.67 versus 3.24 AE 2.01; 3.29 AE 2.27 versus 4.86 AE 2.20; respectively). Conclusions: Application of EMLA Õ cream can be effectively incorporated as a routine painrelieving intervention within routine vaccination appointments.

The few studies that have reported the incidence of methicillin-resistant Staphylococcus aureus (MRSA) in Saudi Arabia have indicated that a diverse number of circulating MRSA strains have been detected in several major hospitals. Thus, this study was designed to track the presence of MRSA strains in major hospitals in Riyadh, Saudi Arabia, and perform comparative chromosomal DNA analysis of MRSA strains for epidemiological investigation using pulsed-field gel electrophoresis (PFGE). Correlation of the PFGE types generated with microbiological and clinical data of the isolates was attempted. Screening for decreased susceptibility to vancomycin among the isolates was also done. A dendogram was generated using PFGE macrorestriction fragments and 6 types were identified (M1-M6) with M1 being predominant and widespread. A clear link between PFGE types and some clinical and microbiological data available for the strains was found. For example, M1 was statistically associated with male patients, whereas the unique types were associated with female patients, M2 was associated with isolates from wounds and age group <5 years, and M4 was associated with isolates from patients admitted to intensive care units. M5 was highly correlated with low sensitivity to linezolid. No vancomycin-resistant isolates were detected.