Reply to Handsfield

TOTHE EDITOR—Handsfield [1] questions the conclusion of our recently published article describing heterosexual transmission of community-associated methicillin-resistant Staphylococcus aureus (MRSA) infection [2]. The focus of his comments is whether community-associated MRSA infection should be considered to be a sexually transmitted disease. This was not the conclusion or the focus of the paper. The issue of whether community-associated MRSA infection should be considered to be a sexually transmitted disease was mentioned in a single sentence in the discussion section of our report. The focus of the article, however, was the observation that heterosexual activity was a potentially important and previously unappreciated means of community-associated MRSA transmission. This observation may have considerable relevance to the transmission of these strains outside of traditional outbreak settings (e.g., in jails, sports teams, or day care facilities) into the more general community. We are happy to leave the discussion as to whether community-associated MRSA infection should be considered to be a sexually transmitted disease to the "specialists."

acknowledgments

Potential conflicts of interest. H.H.H.: no conflicts.