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To determine changes in the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA), a prospective study was conducted for a 30-month period in a university hospital in the eastern province of Saudi Arabia. Of 1,096 Staphylococcus aureus isolates identified, 92 (8.4%) were MRSA. Seventy-two (78%) of the 92 isolates were from nosocomial cases and 20 (22%) isolates were from community cases. Thirteen (14%) of 20 patients with community-acquired MRSA had no discernible risk factors. The community-acquired MRSA from patients without identified risk were susceptible to a greater number of antimicrobials compared with isolates obtained from patients with community-acquired MRSA with identified risk or with nosocomially acquired MRSA. No strain resistant to vancomycin was recorded in this study. The impact of these organisms could be substantial if they become more frequent or widespread.

A rapid increase in the rate of cholecystectomy was reported in eastern Saudi Arabia between 1977 and 1986. The aim of this study was to determine whether the rate of cholecystectomy in the same region was still rising after the introduction of laparoscopic cholecystectomy. From 1987 to 1995 a total of 24 hospitals in eastern Saudi Arabia were surveyed using a questionnaire. During the 9-year study period, the rate of total cholecystectomy (open and laparoscopic) increased by 91%. Whereas the cholecystectomy rate decreased by 4% per annum from 1987 to 1990, it increased by 63.7% from 1991 to 1995 after the introduction of laparoscopic cholecystectomy. The increase in the rates of cholecystectomy was observed in all age groups and both sexes. Cholecystectomy was, however, most frequent among the age group 45-64 years followed by the age group 25-44 years. Young and female patients were more likely to undergo laparoscopic cholecystectomy than the open procedure. The rise in cholecystectomy rate deserves further evaluation with regard to the following: reasons for the increased rate of cholecystectomy, cholecystectomy-related morbidity and mortality, and the total costs of cholecystectomy.