BACKGROUND AND OBJECTIVE: Since the early 2000s, the incidence of 
methicillin-resistant Staphylococcus aureus (MRSA) infections among the 
community of people lacking known healthcare risk factors has increased. This 
MRSA infection is referred to as community-associated MRSA (CA-MRSA) infection 
and is distinct from hospital-associated MRSA (HA-MRSA) infection, which occurs 
among people with known healthcare risk factors. Understanding the epidemiology 
of CA-MRSA infections is critical; however, this has not been investigated in 
detail in Japan. Our objective was to investigate the incidence of CA-MRSA 
infections in a regional hospital.
PATIENTS AND METHODS: We investigated CA-MRSA isolates and infections in a rural 
regional hospital by reviewing medical records of one year. Infections were 
classified as CA-MRSA if no established risk factors were identified.
RESULTS: During 2008, 31 Staphylococcus aureus (S. aureus) isolates were 
detected in 29 unique patients, with 1 methicillin-sensitive S. aureus (MSSA) 
isolates obtained from 19 patients (66%) and MRSA obtained from 10 patients 
(34%). In the 10 patients with MRSA, the number of HA-MRSA and CA-MRSA cases 
were nine (32% of patients with S. aureus isolates) and one (3%), respectively. 
The patient with CA-MRSA was diagnosed with cellulitis due to CA-MRSA. All nine 
patients with HA-MRSA exhibited colonization.
CONCLUSION: We observed a CA-MRSA case in a regional hospital in Japan, 
suggesting that incidence trends of CA-MRSA should be considered in future 
research and treatment.