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Some pathogens are spread by skin-to-skin contact. In Chapter 1, “Introduction to the Resistance Problem,” we briefly described situations involving S. aureus. Although hospital outbreaks of MRSA have been common since the 1970s, community-associated forms began to emerge only in the late 1990s. Examples involving military recruits and sports teams are consistent with transmission occurring by skin-to-skin contact and sharing personal items (see Box 7-8).