Community-associated methicillin-resistant Staphylococcus aureus ST8 ("USA300") in an HIV-positive patient in Cologne, Germany, February 2008

The first cases of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) were reported in 1996 in Minnesota, United States (US) and were deep-seated skin and soft tissue infections and a few cases of necrotising pneumonia, mainly in children and among the Native American population [1]. A few years later, a large outbreak of CA-MRSA infections was reported in the men who have sex with men (MSM) community in California, predominantly among human immunodeficiency virus (HIV)-positive patients; data on sexual transmission was not available [2]. A recent report on the spread of CA-MRSA, mainly due to the widely disseminated strain ""USA300"", in numerous MSM in San Francisco and in one patient in Boston suggested sexual transmission [3], but initiated critical reviews concerning the transmission route and the corresponding public health message [4,5].