BackgroundSince the 1990s, community-associated methicillin resistant staphylococcus aureus (CA-MRSA) has emerged as an important global cause of skin and soft tissue infections. Little is known about the epidemiology of this pathogen in the Middle East.MethodsWe conducted a prospective observational study in a single large teaching hospital in Dubai to identify the incidence of community-acquired methicillin resistant staphylococcus aureus (MRSA) among ambulatory patients presenting with purulent skin and soft tissue infections. We performed wound cultures and administered standard questionnaires to 100 cases presenting to the emergency department. Bivariate and multivariate analyses were performed to identify risk factors for MSRA versus other pathogens.ResultsThe prevalence of MRSA was 23% (18/78) among 78 culture-positive isolates and 29% (18/62) among Staphylococcus-positive isolates. 74% received antibiotics of which 4/74 (5%) received antibiotics appropriate for CA-MRSA infections. Multivariate adjusted analysis identified playing contact sports (OR 5.9 [95% CI 1.3–27.1]) and female sex (OR 6.3 [95% CI 1.6–24.8]) as independent risks for MRSA infection.ConclusionsThis is the first study to describe the epidemiology of CA-MRSA in the ambulatory setting in the Middle East and demonstrates a substantial proportion of cases presenting with skin and soft tissue infections were CA-MRSA. Although most skin and soft tissue infections are abscesses for which the cornerstone of treatment is high quality incision and drainage, if adjunct antibiotics are prescribed in this setting, CA-MRSA-active antibiotics should be considered.

IntroductionSphingobacterium multivorum is a Gram-negative, nonfermentative bacillus that rarely causes disease in humans. In the medical literature, only a few cases of infections caused by this organism have been reported. Almost all the reported cases of this infection were associated with conditions that decrease immunity.Case PresentationTo the best of our knowledge, we are reporting the first case of bacteremia and acute meningitis caused by S. multivorum in a young immunocompetent adult.

Background: Gram-negative organisms harbouring carbapenem resistance genes (CRGs) are spreading globally, including in Gulf Cooperation Council (GCC) countries. However, relatively few data are available about carriage of CRGs in hospitalized patients in this region. Aim: To determine prevalence of CRG carriage and risk factors for colonization among patients in GCC hospitals. Methods: Rectal swabs were obtained from w50 intensive care unit (ICU) patients from each of 11 hospitals in five GCC countries between March and November 2019. The swabs were tested for the presence of bla KPC , bla NDM , bla VIM , bla IMP , and bla OXA-48 CRG using a commercial polymerase chain reaction test. Data on risk factors for colonization were collected and analysed. Findings: Of 529 specimens screened, 138 (26.1%) were positive for one or more CRGs. The positivity rates among the hospitals ranged from 8.0% to 67.3%; w20% of the positive specimens harboured 2 CRGs. The most common CRG detected was bla OXA-48 , which was present in 82 specimens (15.5%). Additional CRGs included bla NDM , bla VIM , bla KPC , and bla IMP either alone or in combination. Overall, 31.1% of patients on antibiotics on admission to the ICU were positive for CRGs compared to 16.5% not on antibiotic therapy (P <

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