Zakażenie mrsa – Epidemiologia

Zakażenie mrsa
Epidemiologia

Methicillin-resistant Staphylococcus aureus (MRSA) jest istotnym patogenem zarówno w środowisku szpitalnym, jak i pozaszpitalnym, wykazującym oporność na beta-laktamowe antybiotyki, w tym metycylinę. Globalna częstość występowania MRSA wynosi średnio 14,69% (95% CI 12,39-17,15%), z najwyższym odsetkiem w Ameryce (22,27%) i najniższym w Europie (10,93%). W Niemczech MRSA stanowi 18-20% izolatów S. aureus u pacjentów hospitalizowanych. Zakażenia MRSA dzieli się na szpitalne (HO-MRSA), pozaszpitalne związane z opieką zdrowotną (HACO-MRSA) oraz pozaszpitalne (CA-MRSA), przy czym granice między nimi ulegają zatarciu. Epidemiologia MRSA ulega dynamicznym zmianom, z obserwowanym spadkiem HO-MRSA w latach 2005-2012, ale stabilizacją lub wzrostem CA-MRSA w niektórych regionach, np. wzrostem zakażeń krwi w Kanadzie z 0,84 do 1,13 na 10 000 osobodni w latach 2017-2021. Czynniki ryzyka różnią się w zależności od typu zakażenia i obejmują m.in. hospitalizację, procedury inwazyjne, kolonizację, a także czynniki środowiskowe i kontakt ze zwierzętami. Transmisja MRSA odbywa się głównie przez kontakt fizyczny oraz zanieczyszczone powierzchnie, a zdolność do tworzenia biofilmu zwiększa jego przetrwanie i oporność.

Epidemiologia zakażeń MRSA

Methicillin-resistant Staphylococcus aureus (MRSA) stanowi jeden z głównych patogenów wywołujących zakażenia zarówno w środowisku szpitalnym, jak i pozaszpitalnym. MRSA jest szczepem Staphylococcus aureus, który wykazuje oporność na antybiotyki beta-laktamowe, w tym metycylinę, oksacylinę, penicylinę i amoksycylinę, co znacząco utrudnia leczenie¹. Ze względu na ciągły wzrost częstości występowania i transmisji MRSA w szpitalach, społeczności i środowiskach weterynaryjnych, patogen ten stanowi istotne zagrożenie dla zdrowia publicznego². Według Centrum Kontroli i Zapobiegania Chorobom (CDC), w 2017 roku w Stanach Zjednoczonych odnotowano prawie 120 000 przypadków zakażeń krwi wywołanych przez Staphylococcus aureus, które przyczyniły się do około 20 000 zgonów³.

Częstość występowania MRSA różni się znacznie w zależności od regionu geograficznego. Globalna metaanaliza wykazała, że średnia światowa częstość występowania MRSA wynosi 14,69% (95% CI 12,39-17,15%)⁴. Najwyższy odsetek kolonizacji MRSA odnotowano w krajach amerykańskich (22,27%), a najniższy w Europie (10,93%)⁵. W Niemczech MRSA stanowi od 18% do 20% wszystkich izolatów S. aureus pochodzących od pacjentów hospitalizowanych⁶. Szacuje się, że w europejskich systemach opieki zdrowotnej występuje około 170 000 zakażeń MRSA rocznie, powodując ponad 5000 zgonów, ponad 1 milion dodatkowych dni hospitalizacji i dodatkowe koszty wynoszące około 380 milionów euro⁷.

Klasyfikacja zakażeń MRSA

Zakażenia MRSA klasyfikuje się zazwyczaj na trzy główne kategorie w zależności od środowiska, w którym doszło do zakażenia:⁸⁹

Szpitalne zakażenia MRSA (Hospital-Onset, HO-MRSA) – nabyte podczas pobytu w placówce opieki zdrowotnej
Pozaszpitalne zakażenia związane z opieką zdrowotną (Healthcare-Associated Community-Onset, HACO-MRSA) – występujące u pacjentów mających kontakt z systemem opieki zdrowotnej, ale nabyte poza szpitalem
Pozaszpitalne zakażenia MRSA (Community-Associated, CA-MRSA) – nabyte w środowisku pozaszpitalnym, bez kontaktu z systemem opieki zdrowotnej

Historycznie, zakażenia MRSA związane z opieką zdrowotną (HA-MRSA) i pozaszpitalne zakażenia MRSA (CA-MRSA) różniły się pod względem klinicznej i molekularnej epidemiologii¹⁰. Jednak granice między tymi kategoriami zacierają się wraz z pojawieniem się szczepów CA-MRSA w środowisku szpitalnym¹¹.

Trendy epidemiologiczne MRSA

W ostatnich latach obserwuje się zmieniające się trendy w epidemiologii zakażeń MRSA. Historia MRSA sięga 1961 roku, kiedy to po raz pierwszy opisano ten patogen. Od tego czasu częstość występowania i rozpowszechnienie zakażeń MRSA dramatycznie wzrosły na całym świecie¹². Dane z programu nadzoru aktywnych rdzeni bakteryjnych (ABCs) CDC pokazują, że częstość występowania szpitalnych zakażeń MRSA (HO-MRSA) zmniejszała się o 17,1% rocznie w latach 2005-2012, ale w latach 2013-2016 te spadki wyraźnie spowolniły¹³.

Jednocześnie częstość występowania pozaszpitalnych zakażeń MRSA (CA-MRSA) pozostaje na względnie stałym poziomie, a w niektórych regionach obserwuje się nawet wzrost¹⁴. Przykładowo, w badaniu przeprowadzonym w Pakistanie wykryto 15,6% LA-MRSA (Livestock-Associated MRSA, MRSA związanego ze zwierzętami hodowlanymi) w mleku kozim, 24,5% w mleku krowim, 30,4% u kotów i 33,9% u psów¹⁵. Wzrost częstości występowania CA-MRSA może być częściowo przypisany rozprzestrzenianiu się wirulentnego szczepu USA-300, który pojawił się w późnych latach 90. XX wieku¹⁶.

W niektórych krajach, jak np. w Kanadzie, zaobserwowano wzrost częstości występowania zakażeń krwi wywołanych przez MRSA o 35% w latach 2017-2021, od 0,84 do 1,13 zakażeń na 10 000 osobodni¹⁷. Z kolei w Quebecu (Kanada) częstość występowania HA-MRSA-BSI (szpitalnych zakażeń krwi wywołanych przez MRSA) zmniejszyła się z 0,54 na 10 000 osobodni w latach 2006-2007 do 0,14 na 10 000 osobodni w latach 2016-2017¹⁸.

W Norwegii, kraju o niskiej częstości występowania MRSA, zaobserwowano znaczący wzrost częstości występowania MRSA w latach 2008-2017, głównie z powodu wzrostu CA-MRSA i nosicielstwa MRSA, podczas gdy częstość występowania zakażeń inwazyjnych pozostała na stosunkowo niskim poziomie¹⁹.

Czynniki ryzyka zakażenia MRSA

Czynniki ryzyka zakażenia MRSA różnią się w zależności od typu zakażenia (szpitalne czy pozaszpitalne). Do głównych czynników ryzyka zakażenia HA-MRSA należą:²⁰

Przedłużona hospitalizacja
Przyjęcie na oddział intensywnej terapii
Niedawna hospitalizacja
Wcześniejsze stosowanie antybiotyków
Kolonizacja MRSA
Procedury inwazyjne
Zakażenie HIV
Pobyt w domach opieki
Otwarte rany
Hemodializa
Wypis ze szpitala z długoterminowym centralnym dostępem żylnym lub długotrwałym cewnikiem moczowym

Wyższą częstość występowania zakażeń MRSA obserwuje się również wśród pracowników służby zdrowia, którzy mają bezpośredni kontakt z pacjentami zakażonymi tym drobnoustrojem²¹.

Dla zakażeń CA-MRSA, CDC zidentyfikowało tzw. „5 C” jako czynniki ryzyka:²²

Crowding (zatłoczenie)
Close contact (bliski kontakt)
Compromised skin (uszkodzona skóra)
Contaminated surfaces (zanieczyszczone powierzchnie) i wspólne przedmioty osobiste
Brak Cleanliness (czystości)

Do grup szczególnie narażonych na zakażenie CA-MRSA należą sportowcy, uczniowie przedszkoli i szkół, personel wojskowy w koszarach, osoby otrzymujące opiekę szpitalną, osoby poddawane zabiegom chirurgicznym lub mające wprowadzone do organizmu urządzenia medyczne oraz osoby przyjmujące narkotyki drogą dożylną²³.

Badania wykazały również, że ryzyko zakażenia MRSA u osób opiekujących się zwierzętami (1,7%) było wyższe w porównaniu z osobami, które nie miały kontaktu ze zwierzętami²⁴. Kontakt z zakażonymi członkami rodziny może również zwiększać ryzyko zakażenia. Badanie przeprowadzone na dużej bazie danych ubezpieczeniowych wykazało, że osoby narażone na niedawno hospitalizowanego członka rodziny z MRSA były ponad 71 razy (7000%) bardziej narażone na zakażenie MRSA w porównaniu z osobami, których członkowie rodziny nie byli hospitalizowani lub narażeni na MRSA w ciągu ostatnich 30 dni²⁵.

Transmisja MRSA

Transmisja MRSA między różnymi gospodarzami odbywa się przede wszystkim poprzez kontakt fizyczny ze źródłem²⁶. Bakterie MRSA (w tym MRSA) rozprzestrzeniają się poprzez kontakt z zakażonymi osobami, ranami lub przedmiotami, które dotykały zakażonej skóry i przenoszą bakterie (np. ręczniki, maszynki do golenia, maty sportowe)²⁷.

W środowisku szpitalnym MRSA może być przenoszony przez zanieczyszczone powierzchnie, takie jak poręcze łóżek, urządzenia łazienkowe, sprzęt medyczny i pościel²⁸. Zdolność S. aureus do tworzenia biofilmu na powierzchniach zarówno protetycznych, jak i na tkankach gospodarza pozwala mu przylegać do tych powierzchni, jednocześnie unikając działania środków przeciwdrobnoustrojowych i układu odpornościowego gospodarza²⁹.

HA-MRSA jest przede wszystkim nabywany w środowisku szpitalnym, na przykład z zanieczyszczonych instrumentów, pościeli, drzwi i sprzętu, podczas gdy CA-MRSA jest przede wszystkim nabywany poprzez kontakt fizyczny z zakażoną lub zdrową osobą, ponieważ S. aureus jest bakterią komensalną w jamach nosowych zdrowych osób³⁰.

Transmisja LA-MRSA do ludzi następuje, gdy osoba ma kontakt fizyczny ze zwierzęciem lub środowiskiem³¹. Pojawienie się LA-MRSA i jego przenoszenie na ludzi oraz doniesienia o szczepach ludzkich u zwierząt dodatkowo zwiększają patogenność MRSA, ponieważ teraz MRSA ma różnorodność gatunków gospodarzy, co skutkuje modyfikacją genomową i zwiększa oporność na antybiotyki³².

Systemy nadzoru nad MRSA

Systemy nadzoru monitorujące rozprzestrzenianie się i rozbieżność szczepów MRSA są kluczowe, jeśli środki zapobiegawcze i terapeutyczne skierowane przeciwko zakażeniom MRSA mają być stosowane optymalnie³³. Nadzór dostarcza informacji na temat rozprzestrzeniania się MRSA, pojawiania się nowych szczepów w szpitalach i społecznościach, profilu oporności na antybiotyki i wirulencji szczepów oraz czynników ryzyka związanych z zakażeniem³⁴.

Programy nadzoru nad MRSA

Istnieje wiele krajowych i międzynarodowych programów nadzoru nad MRSA, które śledzą częstość występowania i trendy w zakażeniach MRSA. Oto niektóre z nich:

CDC Emerging Infections Program (EIP) – Program Wschodzących Zakażeń CDC prowadzi aktywny, populacyjny nadzór nad inwazyjnymi zakażeniami MRSA w wybranych regionach USA³⁵³⁶
European Antimicrobial Resistance Surveillance Network (EARS-Net) – Europejska Sieć Nadzoru nad Opornością Przeciwdrobnoustrojową gromadzi dane na temat oporności na antybiotyki, w tym MRSA, z krajów europejskich³⁷
WHO Global Antimicrobial Resistance Surveillance System (GLASS) – Globalny System Nadzoru nad Opornością Przeciwdrobnoustrojową Światowej Organizacji Zdrowia wspiera kraje we wdrażaniu znormalizowanego systemu nadzoru nad opornością przeciwdrobnoustrojową³⁸³⁹
Canadian Nosocomial Infections Surveillance Program – Kanadyjski Program Nadzoru nad Zakażeniami Szpitalnymi monitoruje zakażenia związane z opieką zdrowotną, w tym MRSA, w kanadyjskich szpitalach⁴⁰

W Stanach Zjednoczonych obowiązkowe zgłaszanie zakażeń krwi wywołanych przez MRSA (MRSA BSI) jest wymagane w wielu stanach, a dane są gromadzone przez National Healthcare Safety Network (NHSN) CDC⁴¹. W Niemczech od 2009 roku wprowadzono obowiązkowe zgłaszanie przez laboratoria przypadków MRSA wykrytych w posiewach krwi i płynu mózgowo-rdzeniowego⁴².

W Holandii od 1989 roku funkcjonuje krajowy nadzór nad MRSA o wysokim zasięgu, w ramach którego wszystkie laboratoria mikrobiologii medycznej wysyłają izolaty MRSA do Narodowego Instytutu Zdrowia Publicznego i Środowiska (RIVM) w celu charakteryzacji⁴³.

Metody nadzoru nad MRSA

Istnieją różne podejścia do nadzoru nad MRSA, w tym nadzór pasywny i aktywny. Nadzór pasywny polega na zgłaszaniu przypadków MRSA przez laboratoria lub klinicystów. Nadzór aktywny obejmuje aktywne badanie przesiewowe w celu wykrycia kolonizacji lub zakażenia MRSA, nawet u osób bez objawów⁴⁴.

Aktywny nadzór nad MRSA jest szczególnie ważny w zapobieganiu przenoszeniu i zakażeniom MRSA w placówkach opieki zdrowotnej. Badanie przeprowadzone w szpitalu endemicznym wykazało, że liczba przypadków bakteriemii wywołanej przez MRSA zmniejszyła się z 3,6 przypadków miesięcznie przed interwencją do 1,8 przypadków miesięcznie po interwencji (P < 0,001) po wprowadzeniu aktywnego nadzoru nad MRSA⁴⁵.

Aktywny nadzór nad MRSA jest ważny do identyfikacji ukrytych rezerwuarów MRSA. Izolacja kontaktowa może zapobiegać nowej kolonizacji i zakażeniu oraz prowadzić do znacznego zmniejszenia zachorowalności i kosztów opieki zdrowotnej⁴⁶.

Jednakże badanie przeprowadzone wśród pacjentów oddziałów intensywnej terapii w Illinois wykazało, że częstość występowania kolonizacji MRSA nie zmniejszyła się po wprowadzeniu ustawowo nakazanego aktywnego nadzoru⁴⁷. Badacze zauważyli, że MRSA była oceniana w regionie, gdzie jest szeroko endemiczna, więc wyniki mogą nie mieć zastosowania w regionach o niższych wskaźnikach MRSA⁴⁸.

Sukces standaryzowanego nadzoru w krajach i regionach zależy od prawidłowej diagnozy MRSA i identyfikacji specyficznych wzorców oporności na antybiotyki⁴⁹. Ważnym aspektem rozwoju skutecznych systemów nadzoru jest odpowiednie szkolenie personelu, od mikrobiologów zaangażowanych w monitorowanie MRSA po klinicystów zapewniających opiekę nad pacjentami⁵⁰.

Nadzór genomiczny nad MRSA

Rozwój technologii sekwencjonowania całego genomu (WGS) umożliwił bardziej szczegółową charakterystykę szczepów MRSA i lepsze zrozumienie dróg transmisji. Nadzór genomiczny pomaga wykryć ogniska zakażeń MRSA, które w przeciwnym razie mogłyby pozostać niewykryte⁵¹.

Badanie przeprowadzone w Anglii w latach 2012-2013 wykazało potencjalną użyteczność połączonego nadzoru epidemiologicznego i genomicznego nad bakteriemią wywołaną przez MRSA w celu określenia krajowej struktury populacji MRSA, kontekstualizacji wcześniejszych ognisk MRSA i wykrycia potencjalnie wysokiego ryzyka linii⁵².

Inny przykład użycia nadzoru genomicznego pochodzi z Brooklynu, gdzie badacze wykorzystali sekwencjonowanie genomiczne do zidentyfikowania unikalnego klonu USA300 CA-MRSA rozprzestrzeniającego się w społeczności ortodoksyjnych Żydów⁵³. Badanie to pokazało, że zastosowanie nadzoru genomicznego może pomóc odkryć ogniska i rezerwuary patogenów, które mogłyby zostać zignorowane lub niewykryte⁵⁴.

Trendy i zmiany w epidemiologii MRSA

Epidemiologia MRSA stale się zmienia, a zarówno krążące klony, jak i ich profile oporności na antybiotyki znacznie różnią się w zależności od regionu i kraju⁵⁵. W ostatnich dekadach zaobserwowano znaczące zmiany w epidemiologii MRSA.

Zmiany w częstości występowania MRSA

Od swojego pierwszego opisu w 1961 roku, zakażenia MRSA stały się endemiczne w wielu regionach świata. Częstość występowania MRSA różni się znacznie w zależności od regionu geograficznego i środowiska:

W Stanach Zjednoczonych MRSA stanowi około 10% zakażeń w szpitalach⁵⁶. W amerykańskich oddziałach intensywnej terapii MRSA stanowi ponad 60% izolatów S. aureus⁵⁷.
W Niemczech MRSA stanowi 18-20% wszystkich izolatów S. aureus pochodzących od pacjentów hospitalizowanych⁵⁸.
W niemieckich oddziałach intensywnej terapii MRSA stanowi 24% izolatów⁵⁹.
W Quebecu (Kanada) odsetek oporności na metycylinę w zakażeniach krwi związanych z opieką zdrowotną wywołanych przez S. aureus zmniejszył się stopniowo od 2010-2011, osiągając 12,6% w latach 2015-2016⁶⁰.

Globalna częstość występowania MRSA waha się od poniżej 5% do ponad 80%, stanowiąc istotne obciążenie w wielu krajach⁶¹. W badaniu przeprowadzonym w Arabii Saudyjskiej ogólna roczna częstość występowania MRSA wynosiła 25 przypadków na 100 000 pacjentów (27% wszystkich izolatów S. aureus)⁶².

Zmiany w strukturze populacji MRSA

W ostatnich latach zaobserwowano znaczące zmiany w strukturze populacji MRSA, w tym wzrost częstości występowania CA-MRSA i LA-MRSA. W badaniu przeprowadzonym w Arabii Saudyjskiej, mimo że większość (64%) zakażeń MRSA występowała w środowisku opieki zdrowotnej, izolacja CA-MRSA stale rosła z 23% w 2006 r. do 60% w 2015 r., przekraczając wskaźnik izolacji HA-MRSA⁶³.

W Holandii zaobserwowano wzrost odsetka izolatów dodatnich pod względem PVL (leukocydyny Panton-Valentine) z 15% w latach 2008-2010 do 25% w latach 2017-2019⁶⁴. PVL jest czynnikiem wirulencji często związanym z CA-MRSA.

W Norwegii częstość występowania MRSA na 100 000 populacji wzrosła o 15% rocznie, z 14,2 w 2007 r. do 48,6 w 2017 r. Ten wzrost był głównie spowodowany nosicielstwem MRSA i przypadkami CA-MRSA⁶⁵.

W populacji pediatrycznej w Stanach Zjednoczonych zaobserwowano wzrost częstości występowania inwazyjnych zakażeń CA-MRSA z 1,1 przypadku na 100 000 dzieci w 2005 r. do 1,7 przypadku na 100 000 w 2010 r.⁶⁶. Analiza potwierdziła, że inwazyjne zakażenia CA-MRSA są coraz częstsze wśród dzieci, szczególnie wśród dzieci rasy czarnej i niemowląt poniżej 90 dnia życia⁶⁷.

Wpływ pandemii COVID-19 na epidemiologię MRSA

Pandemia COVID-19 miała znaczący wpływ na epidemiologię zakażeń MRSA. Podczas pandemii zakażenia MRSA w szpitalach opieki doraźnej gwałtownie wzrosły, mimo spadku zakażeń przed pandemią⁶⁸. Według danych CDC, w pierwszym roku pandemii postęp w walce ze śmiertelnymi zakażeniami opornymi na środki przeciwdrobnoustrojowe odwrócił się⁶⁹.

Dane z programu nadzoru EIP MRSA CDC wykazały, że częstość HO-MRSA wzrosła w porównaniu z latami 2017-2019, podczas gdy częstość HACO i CA-MRSA zmniejszyła się, przerywając poprzednie wzrosty od 2017 r.⁷⁰.

Wpływ zakażeń MRSA na zdrowie publiczne

Zakażenia MRSA mają znaczący wpływ na zdrowie publiczne, powodując wysoką zachorowalność, śmiertelność i koszty opieki zdrowotnej.

Zachorowalność i śmiertelność związana z MRSA

MRSA jest znane jako główne zagrożenie dla zdrowia publicznego ze względu na rosnącą częstość występowania w szpitalach, społeczności i wśród zwierząt, transmisję między ludźmi i zwierzętami, wskaźniki zakażeń, oporność i problemy terapeutyczne⁷¹. Wśród 100 000 przypadków zakażeń MRSA rocznie, 20% pacjentów umiera⁷².

W Kanadzie 30-dniowa śmiertelność związana z zakażeniami krwi wywołanymi przez MRSA (HA-MRSA-BSI) wynosiła 26,4% w latach 2015-2016⁷³. W stanie Georgia (USA) współczynnik śmiertelności związanej z ciężkimi zakażeniami CA-MRSA wynosił 34% (56/1670) w okresie objętym nadzorem⁷⁴.

Zakażenia MRSA mogą być szczególnie niebezpieczne dla określonych populacji, takich jak osoby starsze, pacjenci z obniżoną odpornością i niemowlęta. Odnotowano, że MRSA powoduje głównie zakażenia skóry i tkanek miękkich prowadzące do bakteriemii, co prowadzi do wyższych wskaźników śmiertelności wahających się od 15% do 60%⁷⁵.

Obciążenie ekonomiczne związane z MRSA

Zakażenia MRSA wiążą się ze znacznymi kosztami ekonomicznymi dla systemów opieki zdrowotnej. Szacowano, że roczny koszt zdrowotny z powodu zakażeń MRSA wynosi 3 miliardy dolarów⁷⁶. W Stanach Zjednoczonych zakażenia S. aureus (SA) i MRSA obciążają system opieki zdrowotnej odpowiednio około 9,5 miliarda i 20 miliardów dolarów rocznie w kosztach opieki⁷⁷.

Zakażenia MRSA u noworodków są związane z dłuższym pobytem w szpitalu i wyższymi kosztami. Liczba zakażeń u noworodków wzrosła o 308% w latach 1995-2004, a każde zakażenie było związane z dodatkowym 40-dniowym pobytem pacjenta i wydatkiem 164 301 dolarów w szpitalu⁷⁸.

Szacunki z Europy wskazują, że zakażenia MRSA powodują ponad 1 milion dodatkowych dni hospitalizacji i dodatkowe koszty wynoszące około 380 milionów euro rocznie⁷⁹.

Strategie zapobiegania i kontroli MRSA

Zapobieganie i kontrola zakażeń MRSA wymagają podejścia wieloaspektowego, które obejmuje nadzór, higiena rąk, środki izolacji kontaktowej i dekolonizacja.

Rola nadzoru w zapobieganiu MRSA

Nadzór jest ważnym narzędziem, które pomaga we wdrażaniu różnych środków zapobiegawczych i terapeutycznych mających na celu zwalczanie zakażeń MRSA w społeczności i w szpitalach⁸⁰. Ogólnym celem nadzoru w zdrowiu publicznym jest dostarczanie informacji w celu zmniejszenia zachorowalności i śmiertelności oraz poprawy zdrowia⁸¹.

Aktywny nadzór dla MRSA jest szczególnie ważny w identyfikacji ukrytych rezerwuarów MRSA⁸². Badanie przeprowadzone w norweskich szpitalach wykazało, że polityka „poszukiwania i niszczenia” była skuteczna w zapobieganiu endemiczności MRSA w norweskich instytucjach opieki zdrowotnej⁸³.

Częsty nadzór nad MRSA może zawierać zakażenie u noworodków. Badanie wykazało, że w porównaniu z comiesięcznym nadzorem, cotygodniowe kontrole obniżyły liczbę niemowląt skolonizowanych przez MRSA o około 80%, ze średniej 2,9 do 0,6⁸⁴.

Środki zapobiegania i kontroli zakażeń

Kluczem do zarządzania zakażeniami MRSA jest zapobieganie im w pierwszym miejscu⁸⁵. W ciągu lat wydano wiele wytycznych, a większość szpitali ma zespół ekspertów ds. chorób zakaźnych jako część szpitalnego zespołu interprofesjonalnego, który prowadzi nadzór i monitoruje ogniska MRSA⁸⁶.

Środki zapobiegania i kontroli zakażeń MRSA obejmują:⁸⁷

Higiena rąk – Jest najważniejsza i powinna być rygorystycznie praktykowana przez wszystkich pracowników służby zdrowia, pacjentów i odwiedzających
Stosowanie środków ochrony osobistej – Takich jak rękawiczki i fartuchy, może pomóc w zminimalizowaniu ryzyka transmisji
Wdrażanie środków ostrożności kontaktowej – W tym izolacja zakażonych lub skolonizowanych pacjentów, może dodatkowo zmniejszyć rozprzestrzenianie się MRSA
Programy aktywnego nadzoru – Odgrywają kluczową rolę w identyfikacji MRSA

W środowisku szpitalnym osoby zakażone lub skolonizowane MRSA często są umieszczane w izolacji jako środek zapobiegający rozprzestrzenianiu się MRSA⁸⁸. Pomieszczenia szpitalne, powierzchnie i sprzęt, a także przedmioty prane, muszą być odpowiednio dezynfekowane i regularnie czyszczone⁸⁹.

Dekolonizacja MRSA

Dekolonizacja jest strategią mającą na celu eliminację MRSA z organizmu nosiciela. Może być przeprowadzona w sposób ukierunkowany (tylko u osób z potwierdzonym MRSA) lub uniwersalny (u wszystkich pacjentów w określonym środowisku, np. oddział intensywnej terapii).

Duże wieloośrodkowe badanie wykazało, że uniwersalna dekolonizacja jest bardziej skuteczna niż dekolonizacja ukierunkowana lub badania przesiewowe i izolacja w zmniejszaniu wskaźników klinicznych izolatów MRSA i zakażeń krwi u pacjentów na oddziale intensywnej terapii⁹⁰.

Istnieją dowody, że podejście uniwersalnej dekolonizacji (donosowa mupirocyna plus kąpiele w glukonianie chlorheksydyny dla wszystkich pacjentów na oddziale intensywnej terapii, z zaprzestaniem aktywnego nadzoru nad MRSA) jest lepsze, ale według badaczy, obecne prawo nie pozwala szpitalom na zaprzestanie obowiązkowych badań przesiewowych i przyjęcie bardziej skutecznego podejścia⁹¹.

Wyzwania i przyszłe kierunki w nadzorze nad MRSA

Pomimo postępów w zrozumieniu epidemiologii MRSA i rozwoju strategii zapobiegania, wciąż istnieją znaczące wyzwania i obszary wymagające dalszych badań.

Wyzwania w nadzorze nad MRSA

Jednym z głównych wyzwań w nadzorze nad MRSA jest ograniczenie zasobów. Nadzór nad MRSA, szczególnie aktywny nadzór wymagający badań przesiewowych, może być kosztowny. W badaniu symulacyjnym wykazano, że przez sześć miesięcy program cotygodniowego nadzoru kosztowałby od 15 000 do 98 000 dolarów, podczas gdy program raz na cztery tygodnie oszacowano na 3 500 do 23 000 dolarów, czyli około cztery razy mniej kosztowny⁹².

Inne wyzwania obejmują brak standaryzacji definicji przypadku i praktyk nadzoru między różnymi regionami i krajami, co utrudnia porównania i śledzenie trendów globalnych. Mimo wysiłków, zasoby do monitorowania zmieniającej się epidemiologii MRSA pozostają ograniczone, a prawdziwa natura i zasięg zakażeń MRSA w regionie nie są dobrze zrozumiane⁹³.

Wyzwaniem jest również opóźnione wykrywanie transmisji MRSA. Badanie genomiczne wykazało, że zdarzenia transmisji prowadzące do inwazyjnych, opornych na antybiotyki zakażeń mogą wystąpić na długo przed zdiagnozowaniem zakażeń, również w społeczności⁹⁴. Jeśli czeka się do momentu wystąpienia zakażeń, może być zdecydowanie za późno, aby zapobiec zakażeniu innych osób tymi samymi szczepami⁹⁵.

Przyszłe kierunki w nadzorze nad MRSA

Przyszłe kierunki w nadzorze nad MRSA obejmują szersze wykorzystanie sekwencjonowania całego genomu (WGS) i innych zaawansowanych technik molekularnych do monitorowania rozprzestrzeniania się i ewolucji szczepów MRSA. Sekwencjonowanie całego genomu może dostarczyć cennych informacji na temat dróg transmisji i obecności genów wirulencji i oporności⁹⁶.

Potrzebne są również szersze i skoordynowane programy dostarczające regularnych raportów z nadzoru, aby wspierać klinicystów i komitety kontroli zakażeń w obliczu wyzwań związanych z leczeniem i zapobieganiem zakażeniom wywołanym przez MRSA⁹⁷.

Ważne jest również zwiększenie integracji danych z różnych systemów nadzoru i rozwój strategii ukierunkowanych na specyficzne rezerwuary MRSA, takie jak społeczność, placówki opieki długoterminowej i środowiska weterynaryjne.

Rozwijanie nowych sposobów zwalczania oporności na antybiotyki i produkcja szczepionek są bardzo ważne w tej erze⁹⁸. Profilaktyka i kontrola zakażeń MRSA wymagają kompleksowego podejścia, które integruje nadzór, zapobieganie, kontrolę i stosowanie odpowiednich antybiotyków.

Podsumowanie znaczenia nadzoru nad MRSA

Nadzór nad MRSA odgrywa kluczową rolę w zrozumieniu epidemiologii zakażeń MRSA, identyfikacji czynników ryzyka i ocenie skuteczności interwencji. Dostarcza cennych informacji dla decydentów w zakresie zdrowia publicznego i pomaga formułować ramy podejść do dalszego zapobiegania zakażeniom MRSA⁹⁹.

Spójny i znormalizowany nadzór nad epidemiologicznymi i laboratoryjnymi danymi dotyczącymi zakażeń związanych z opieką zdrowotną jest niezbędny do zapewnienia pracownikom szpitali wskaźników referencyjnych i informowania o politykach zapobiegania i kontroli zakażeń oraz zarządzania antybiotykami, aby pomóc zmniejszyć obciążenie zakażeniami związanymi z opieką zdrowotną i wpływ oporności na środki przeciwdrobnoustrojowe w szpitalach opieki doraźnej¹⁰⁰.

Biorąc pod uwagę znaczący wskaźnik MRSA, programy badań przesiewowych i środki zapobiegawcze powinny być ukierunkowane na MRSA w domach opieki dla osób starszych ze względu na wysokie globalne wskaźniki występowania¹⁰¹. Szpitalne elektroniczne systemy danych zdrowotnych w połączeniu z analizami przestrzennymi mogą zapewnić skuteczny system nadzoru, który mógłby być wykorzystany do opracowania strategii zapobiegania transmisji CA-MRSA¹⁰².

Wraz z pojawieniem się nowych szczepów MRSA i zmieniającymi się wzorcami oporności, ciągły nadzór nad MRSA pozostaje niezbędny do monitorowania trendów i identyfikowania nowych zagrożeń. Tylko poprzez skoordynowane wysiłki w zakresie nadzoru, zapobiegania i kontroli możemy mieć nadzieję na ograniczenie wpływu tego ważnego patogenu na zdrowie publiczne.

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Materiały źródłowe

#1 Health: Infectious Disease Epidemiology & Prevention Division: Methicillin-Resistant Staphylococcus aureus (MRSA)
https://www.in.gov/health/idepd/healthcare-associated-infections-and-antimicrobial-resistance-epidemiology/antimicrobial-resistance/methicillin-resistant-staphylococcus-aureus-mrsa/
Methicillin-resistant Staphylococcus aureus (MRSA) is a bacteria that is often resistant to many antibiotics including methicillin, oxacillin, penicillin, and amoxicillin. […] MRSA infections can be community-acquired, but more serious infections are usually healthcare-acquired. […] The following resources are intended for healthcare professionals and include information about preventing the spread of MRSA in healthcare settings. […] Guide to Elimination of Methicillin-Resistant Staphylococcus aureus Transmission in Hospital Settings, APIC. […] ISDA Management of Patients with Infections Caused by MRSA.
#2 MRSA compendium of epidemiology, transmission, pathophysiology, treatment, and prevention within one health framework
https://pmc.ncbi.nlm.nih.gov/articles/PMC9871788/
Staphylococcus aureus is recognized as commensal as well as opportunistic pathogen of humans and animals. Methicillin resistant strain of S. aureus (MRSA) has emerged as a major pathogen in hospitals, community and veterinary settings that compromises the public health and livestock production. […] Due to the continuous increasing prevalence and transmission of MRSA in hospitals, community and veterinary settings posing a major threat to public health. Furthermore, high pathogenicity of MRSA due to a number of virulence factors produced by S. aureus along with antibiotic resistance help to breach the immunity of host and responsible for causing severe infections in humans and animals. […] The clinical manifestations of MRSA consist of skin and soft tissues infection to bacteremia, septicemia, toxic shock, and scalded skin syndrome.
#3 Vital Signs: Epidemiology and Recent Trends in Methicillin-Resistant and in Methicillin-Susceptible Staphylococcus aureus Bloodstream Infections â United States | MMWR
https://www.cdc.gov/mmwr/volumes/68/wr/mm6809e1.htm
Invasive methicillin-resistant Staphylococcus aureus (MRSA) infections have been declining in health care settings; however, the rate of decline has recently slowed. […] Nearly 120,000 Staphylococcus aureus bloodstream infections and 20,000 associated deaths occurred in the United States in 2017. After years of progress, the rate of decline of MRSA bloodstream infections has slowed, whereas bloodstream infections caused by methicillin-susceptible S. aureus are increasing slightly in the community (3.9% annually, 2012-2017). […] Despite reductions in incidence of MRSA bloodstream infections since 2005, S. aureus infections account for significant morbidity and mortality in the United States. […] A critical assessment of recent trends and incidence of both MRSA and MSSA invasive disease in the United States is crucial to informing public health policy and formulating a framework of approaches to further prevent S. aureus infections.
#4 The global prevalence of methicillin-resistant Staphylococcus aureus colonization in residents of elderly care centers: a systematic review and meta-analysis | Antimicrobial Resistance & Infection Control | Full Text
https://aricjournal.biomedcentral.com/articles/10.1186/s13756-023-01210-6
Methicillin-resistant Staphylococcus aureus (MRSA) is a difficult to treat infection, particularly in residents of elderly care centers (ECCs). Despite the substantial burden of MRSA, an inadequate number of studies have analyzed MRSA prevalence in ECCs. […] We conducted a worldwide systematic review and meta-analysis on the prevalence and risk factors of MRSA in ECCs. […] The pooled global prevalence of MRSA was 14.69% (95% CI 12.39-17.15%; 16,793/164,717). […] Screening programs and preventive measures should target MRSA in ECCs due to the high global prevalence rates. […] Considering the significant toll of MRSA, monitoring the extent of colonization, and identifying the key risk factors of MRSA acquisition in ECCs is essential for controlling and reducing the burden of this disease in ECCs residents.
#5 The global prevalence of methicillin-resistant Staphylococcus aureus colonization in residents of elderly care centers: a systematic review and meta-analysis | Antimicrobial Resistance & Infection Control | Full Text
https://aricjournal.biomedcentral.com/articles/10.1186/s13756-023-01210-6
Our results showed that the geographic distribution of MRSA colonization is heterogeneous, with the highest and lowest colonization rates reported in countries in regions of the Americas (22.27%) and Europe (10.93%), respectively. […] Our findings identified several risk factors for MRSA colonization in residents of ECCs, such as being male, prior antibiotics use, previous MRSA infection, hospitalization in the past 12 months, presence of any wound, urinary catheter, usage of any invasive medical device, and diabetes. […] This sheds significant light on the essence of targeted interventions and screening programs to locate infected people, control risk factors, and reduce the transmission of MRSA and other MDROs to elderlies living in ECCs.
#6 The Epidemiology of Methicillin-Resistant Staphylococcus aureus (MRSA) in Germany (11.11.2011)
https://di.aerzteblatt.de/int/archive/article/112581
For decades, methicillin-resistant Staphylococcus aureus (MRSA) has been a major cause of infection in hospitals and nursing homes (health care-associated MRSA, HA-MRSA). […] There are about 132 000 cases of MRSA in German hospitals each year. MRSA is found in about 18% to 20% of all inpatient-derived culture specimens that are positive for S. aureus. […] Hospitals and nursing homes were once the main reservoirs of MRSA, but new ones have now emerged outside of the healthcare setting. […] Estimates indicate that there are approximately 170 000 MRSA infections in European healthcare systems each year, causing more than 5000 fatalities, more than 1 million additional inpatient days, and additional costs of approximately 380 million. […] In terms of its incidence rate (the number of cases per 1000 patient days), MRSA remains the most common multidrug-resistant pathogen causing nosocomial infections in Germany.
#7 The Epidemiology of Methicillin-Resistant Staphylococcus aureus (MRSA) in Germany (11.11.2011)
https://di.aerzteblatt.de/int/archive/article/112581
For decades, methicillin-resistant Staphylococcus aureus (MRSA) has been a major cause of infection in hospitals and nursing homes (health care-associated MRSA, HA-MRSA). […] There are about 132 000 cases of MRSA in German hospitals each year. MRSA is found in about 18% to 20% of all inpatient-derived culture specimens that are positive for S. aureus. […] Hospitals and nursing homes were once the main reservoirs of MRSA, but new ones have now emerged outside of the healthcare setting. […] Estimates indicate that there are approximately 170 000 MRSA infections in European healthcare systems each year, causing more than 5000 fatalities, more than 1 million additional inpatient days, and additional costs of approximately 380 million. […] In terms of its incidence rate (the number of cases per 1000 patient days), MRSA remains the most common multidrug-resistant pathogen causing nosocomial infections in Germany.
#8 Invasive Staphylococcus aureus Infection Surveillance | HAIs | CDC
https://www.cdc.gov/healthcare-associated-infections/php/haic-eip/invasive-staphylococcus.html
The Invasive Staphylococcus aureus Infection Surveillance Program collects data for describing incidence and trends of these infections. […] Changes in incidence of hospital-onset (HO), healthcare-associated community-onset (HACO), and community-associated (CA) invasive, methicillin-resistant and methicillin-sensitive S. aureus (MRSA and MSSA) infections. […] Public health professionals and healthcare administrators can use these data to further research and improve S. aureus prevention strategies. […] HO MRSA incidence increased compared to 2017-2019. HACO and CA MRSA incidence decreased, interrupting the previous increases since 2017. […] The invasive S. aureus infection surveillance program is an active population- and laboratory-based surveillance system. Surveillance staff regularly query clinical laboratories to identify microbiological test results among persons living in a defined geographic area.
#9 Invasive MRSA – Allegheny County, PA
https://www.alleghenycounty.us/Services/Health-Department/Community-Indicators-and-Health-Data/Infectious-Disease-Epidemiology/Disease-Surveillance/Invasive-MRSA
Death was reported in 7% of cases. […] Among those with available risk factor data, a majority had had a previous MRSA infection. […] Cases are often classified as hospital-onset (HO), healthcare-associated community-onset (HACO), or community-associated (CA) to describe where exposure might have occurred. […] Invasive MRSA can be prevented from spreading in the community by practicing good hand and body hygiene, covering open cuts or sores, and avoiding sharing personal items like razors. Proper use of contact precautions and personal protective equipment, as well as proper disinfection of surfaces and laundry, can help prevent the spread of invasive MRSA in healthcare settings.
#10 Methicillin-resistant Staphylococcus aureus (MRSA) in adults: Epidemiology – UpToDate
https://www.uptodate.com/contents/methicillin-resistant-staphylococcus-aureus-mrsa-in-adults-epidemiology
Methicillin-resistant Staphylococcus aureus (MRSA) in adults: Epidemiology […] The epidemiology of MRSA infection in adults will be reviewed here. Prevention, control, and treatment of MRSA infections in adults are discussed separately. […] Historically, health care-associated methicillin-resistant S. aureus (HA-MRSA) and community-associated methicillin-resistant S. aureus (CA-MRSA) differed with respect to their clinical and molecular epidemiology.
#11 Epidemiology and risk factors for mortality among methicillin-resistant Staphylococcus aureus bacteremic patients in Southern Brazil | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0283774
This study aimed to evaluate the epidemiology and 30-day mortality of adult patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. We retrospectively reviewed the demographic and clinical data of adult patients with S. aureus bloodstream infections (BSI), admitted to a tertiary public teaching medical center in Porto Alegre, Southern Brazil, from January 2014 to December 2019. A total of 928 patients with S. aureus BSI were identified in the study period (68.5 per 100,000 patient-years), and the proportion of MRSA isolates was 22% (1927%). Thus, 199 patients were included in the analyses. […] Methicillin-resistant S. aureus (MRSA) is challenging in terms of therapeutic strategies, and the occurrence of bacteremia is associated with metastatic infections, recurrence, and high mortality rates (ranging from 15% to 40%). MRSA has a global prevalence ranging from less than 5% to over 80%, being a prominent burden in many countries.
#12 Methicillin-Resistant Staphylococcus aureus – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK482221/
The history of MRSA infection goes back to 1961 when it was first described. Since then, the incidence and prevalence of MRSA infection have been increasing dramatically across the United States. Recently, some population studies have hinted at reducing HA-MRSA incidences in the United States but at the expense of a growing prevalence of CA-MRSA. The reported incidence of MRSA infection ranges from 7% to 60% […] The commonly associated risk factors for MRSA infection are prolonged hospitalization, intensive care admission, recent hospitalization, recent antibiotic use, MRSA colonization, invasive procedures, HIV infection, admission to nursing homes, open wounds, hemodialysis, and discharge with long-term central venous access or long-term indwelling urinary catheter. A higher incidence of MRSA infection is also seen among healthcare workers who come in direct contact with patients infected with this organism.
#13 Vital Signs: Epidemiology and Recent Trends in Methicillin-Resistant and in Methicillin-Susceptible Staphylococcus aureus Bloodstream Infections â United States | MMWR
https://www.cdc.gov/mmwr/volumes/68/wr/mm6809e1.htm
The decline in hospital-onset MRSA bloodstream infection rates has slowed in more recent years: adjusted rates decreased by 17.1% per year during 2005-2012 but did not significantly change during 2013-2016. […] Community-associated MRSA infection rates have changed little overall. […] The recent slowing in the reduction in hospital-onset MRSA bloodstream infections and the limited decline in community-associated MRSA and in MSSA infections point to the need for an updated S. aureus prevention framework, including greater use of evidence-based practices that can reduce transmission and prevent device- and procedure-associated infections, as well as new and novel approaches. […] Community-associated MRSA infections provide a reservoir that contributes to health care-associated disease incidence and fuels transmission both outside and within health care settings. […] The observed increases in rates of community-onset MSSA infections highlight the need to systematically study the epidemiology of MSSA and develop innovative, evidence-based prevention strategies for this setting.
#14 Vital Signs: Epidemiology and Recent Trends in Methicillin-Resistant and in Methicillin-Susceptible Staphylococcus aureus Bloodstream Infections â United States | MMWR
https://www.cdc.gov/mmwr/volumes/68/wr/mm6809e1.htm
The decline in hospital-onset MRSA bloodstream infection rates has slowed in more recent years: adjusted rates decreased by 17.1% per year during 2005-2012 but did not significantly change during 2013-2016. […] Community-associated MRSA infection rates have changed little overall. […] The recent slowing in the reduction in hospital-onset MRSA bloodstream infections and the limited decline in community-associated MRSA and in MSSA infections point to the need for an updated S. aureus prevention framework, including greater use of evidence-based practices that can reduce transmission and prevent device- and procedure-associated infections, as well as new and novel approaches. […] Community-associated MRSA infections provide a reservoir that contributes to health care-associated disease incidence and fuels transmission both outside and within health care settings. […] The observed increases in rates of community-onset MSSA infections highlight the need to systematically study the epidemiology of MSSA and develop innovative, evidence-based prevention strategies for this setting.
#15 MRSA compendium of epidemiology, transmission, pathophysiology, treatment, and prevention within one health framework
https://pmc.ncbi.nlm.nih.gov/articles/PMC9871788/
Rising public concern over MRSA has led to monitoring recommendations, such as information on the prevalence of the infection in healthy dogs, cats, and humans. […] The prevalence of LA-MRSA from different studies also noted higher from different countries as mentioned in Table 1. Recent studies conducted in Pakistan detected 15.6% LA-MRSA from goat milk, 24.5% from cow milk, 30.4% from cats, and 33.9% from dogs. […] Transmission of MRSA among different hosts is primarily known to happen by physical contact with source. […] The capability of transfer of MRSA among different host species including humans and animals is the characteristic feature of MRSA lineages. […] HA-MRSA is primarily acquired from hospital settings such as contaminated instruments, bedding, doors, and equipments while CA-MRSA is primarily acquired by physical contact with infected or healthy person as S. aureus is a commensal bacterial in the nares of healthy individuals.
#16 MRSA | Georgia Department of Public Health
https://dph.georgia.gov/epidemiology/acute-disease-epidemiology/mrsa
Antibiotic resistance in Staphylococcus aureus has been a growing problem since penicillin was first introduced in the 1940s. […] Since the late 1990s, MRSA has become a widespread cause of disease in the community, associated with the emergence of a new and virulent strain known as USA-300. […] In the 8-county Atlanta MSA, the Emerging Infections Program conducts active, laboratory-based surveillance for all cases of MRSA, and classifies them as either community-associated, healthcare-associated community-onset, or healthcare-associated hospital-onset. This surveillance system, although limited geographically, is considered to be a gold standard for quantitative information over time. […] Following multiple outbreak investigations, CDC has characterized risk factors („the 5 C’s”) associated with CA-MRSA disease, which include Crowding, Close contact, Compromised skin, Contaminated surfaces and shared personal items, lack of Cleanliness, and in some outbreaks, prior antimicrobial use.
#17 Canadian surveillance shows rise in MRSA, other healthcare-associated infections | CIDRAP
https://www.cidrap.umn.edu/healthcare-associated-infections/canadian-surveillance-shows-rise-mrsa-other-healthcare-associated
Data collected from 88 Canadian sentinel acute care hospitals from January 2017 through December 2021 show that rates of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs) rose by 35%, climbing from 0.84 to 1.13 infections per 10,000 patient-days. […] The study authors suggest the increase in CA-MRSA BSIs may be linked to a growing CA-MRSA reservoir in Canada, and that strategies that target the reduction and prevention of MRSA, such as screening and eradication of MRSA carriage, may reduce the overall burden of MRSA BSIs. […] „Consistent and standardized surveillance of epidemiologic and laboratory HAI data are essential to providing hospital practitioners with benchmark rates and informing infection prevention and control and antimicrobial stewardship policies to help reduce the burden of HAI and the impact of AMR in Canadian acute care hospitals,” the authors wrote. […] Consistent and standardized surveillance of epidemiologic and laboratory HAI data are essential.
#18 Methicillin-Resistant Staphylococcus aureus Bloodstream Infections Surveillance results: 2016-2017 | Institut national de santÃ© publique du QuÃ©bec
https://www.inspq.qc.ca/en/nosocomial-infections/spin-mrsa/surveillance-results-2016-2017
The HA-MRSA-BSI incidence rate decreased in the past eleven years. It dropped from 0.54 per 10,000 patient days during the first year of mandatory surveillance (2006-2007) to 0.28 in 2012-2013, to reach 0.14 in 2016-2017. […] A total of 232 cases of MRSA bloodstream infections are reported, of which 109 (47.0%) are healthcare-associated. […] The proportion of methicillin resistance in healthcare-associated bloodstream infections due to S. aureus decreased gradually from 2012-2013, reaching 12.1% in 2016-2017. […] In summary, the healthcare facilities, health regions and province did not experience statistically different changes in their HA-MRSA-BSI incidence rate compared to 2015-2016.
#19 Insights from a decade of surveillance: Molecular epidemiology of methicillin-resistant Staphylococcus aureus in Norway from 2008 to 2017 | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0297333
This study highlights that Norway, while still classified as a low-prevalence country, has experienced a significant increase in the incidence of MRSA between 2008 and 2017, which can predominantly be attributed to CA-MRSA and MRSA carriage. […] From 2008 to 2017, there has been a notable rise in the incidence of MRSA in Norway. This increase can be primarily attributed to CA-MRSA and carriage, while the incidence of infections and invasive infections have remained relatively low. Overall, there were significantly more MRSA infections in males than females. Interestingly, there was a significantly higher prevalence of MRSA infections in female young adolescents compared to males. The incidence of HA-MRSA has also increased, although it is still below 10 per 100,000 population. This suggests that the Norwegian „search and destroy” policy has been effective in preventing MRSA from becoming endemic in Norwegian healthcare institutions. Global patterns of travel, migration and work have however had large impact on the MRSA epidemiology in Norway, highlighting the importance of national and international surveillance in order to monitor temporal trends and spread of successful clones.
#20 Methicillin-Resistant Staphylococcus aureus – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK482221/
The history of MRSA infection goes back to 1961 when it was first described. Since then, the incidence and prevalence of MRSA infection have been increasing dramatically across the United States. Recently, some population studies have hinted at reducing HA-MRSA incidences in the United States but at the expense of a growing prevalence of CA-MRSA. The reported incidence of MRSA infection ranges from 7% to 60% […] The commonly associated risk factors for MRSA infection are prolonged hospitalization, intensive care admission, recent hospitalization, recent antibiotic use, MRSA colonization, invasive procedures, HIV infection, admission to nursing homes, open wounds, hemodialysis, and discharge with long-term central venous access or long-term indwelling urinary catheter. A higher incidence of MRSA infection is also seen among healthcare workers who come in direct contact with patients infected with this organism.
#21 Methicillin-Resistant Staphylococcus aureus – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK482221/
The history of MRSA infection goes back to 1961 when it was first described. Since then, the incidence and prevalence of MRSA infection have been increasing dramatically across the United States. Recently, some population studies have hinted at reducing HA-MRSA incidences in the United States but at the expense of a growing prevalence of CA-MRSA. The reported incidence of MRSA infection ranges from 7% to 60% […] The commonly associated risk factors for MRSA infection are prolonged hospitalization, intensive care admission, recent hospitalization, recent antibiotic use, MRSA colonization, invasive procedures, HIV infection, admission to nursing homes, open wounds, hemodialysis, and discharge with long-term central venous access or long-term indwelling urinary catheter. A higher incidence of MRSA infection is also seen among healthcare workers who come in direct contact with patients infected with this organism.
#22 MRSA | Georgia Department of Public Health
https://dph.georgia.gov/epidemiology/acute-disease-epidemiology/mrsa
Antibiotic resistance in Staphylococcus aureus has been a growing problem since penicillin was first introduced in the 1940s. […] Since the late 1990s, MRSA has become a widespread cause of disease in the community, associated with the emergence of a new and virulent strain known as USA-300. […] In the 8-county Atlanta MSA, the Emerging Infections Program conducts active, laboratory-based surveillance for all cases of MRSA, and classifies them as either community-associated, healthcare-associated community-onset, or healthcare-associated hospital-onset. This surveillance system, although limited geographically, is considered to be a gold standard for quantitative information over time. […] Following multiple outbreak investigations, CDC has characterized risk factors („the 5 C’s”) associated with CA-MRSA disease, which include Crowding, Close contact, Compromised skin, Contaminated surfaces and shared personal items, lack of Cleanliness, and in some outbreaks, prior antimicrobial use.
#23 MRSA – Epidemiology
https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/methicillin-resistant-staphylococcus-aureus-mrsa/
Anyone can get MRSA, but some groups have a higher risk. These groups include athletes, daycare and school students, military personnel in barracks, people who receive inpatient medical care, people who have surgery or medical devices inserted in their body, and people who inject drugs. […] Staph bacteria (including MRSA) are spread through contact with infected people, wounds, or things that have touched infected skin and are carrying the bacteria (e.g., towels, razors, athletic mats). […] If the bacteria are resistant to certain antibiotics, a diagnosis of MRSA is made. […] While MRSA can be resistant to several antibiotics, there are antibiotics available to treat MRSA infections. […] Except in special circumstances, treatment is not needed for people who carry MRSA but do not have any symptoms. […] If you are a patient or visitor in a healthcare facility, more strategies for preventing MRSA are available on the CDC website at cdc.gov/mrsa/hcp/infection-control/index.html.
#24 MRSA compendium of epidemiology, transmission, pathophysiology, treatment, and prevention within one health framework
https://pmc.ncbi.nlm.nih.gov/articles/PMC9871788/
LA-MRSA transmission to humans when the individual has physical contact with animal and environment. […] The risk of getting MRSA in animal caretakers (1.7%) was higher compared to those who were not exposed to animals. […] The major steps in pathogenesis of infection are colonization, virulence, initiation of infection, abscess formation, systemic infection, regulation and adaptation with the help of number of virulence factors. […] As MRSA is the methicillin-resistant strain of S. aureus, the S. aureus by self-contain a number of potential virulence factors which includes several surface proteins called microbial surface components recognizing adhesive matrix molecules (MSCRAMMs), which bind to fibrinogen, fibronectin, and collagen fibers of host cells to attack the host tissues. […] The ability of S. aureus to produce biofilm on both prosthetic surfaces and the host allows it to adhere to those surfaces by evading the effect of antimicrobials and host immune system.
#25 Azthena logo with the word Azthena
https://www.news-medical.net/news/20240807/Hospital-discharges-linked-to-higher-MRSA-risk-for-family-members.aspx
Reviewing 424,512 MRSA cases among 343,524 insured people, the study found 4,724 cases of MRSA being potentially transmitted to a family member from a relative who had recently been in the hospital and had a diagnosis of MRSA. […] They also found 8,064 potential transmissions of MRSA after the hospitalization of a family member who did not have a MRSA infection. […] People exposed to a recently hospitalized family member with MRSA were more than 71 times, or 7000%, more likely to get a MRSA infection compared to enrollees who did not have a family member who had been in the hospitalized or exposed to MRSA in the previous 30 days. […] Having a family member in the household who was hospitalized but did not have MRSA increased the chances of a relative getting MRSA in the month after discharge by 44%.
#26 MRSA compendium of epidemiology, transmission, pathophysiology, treatment, and prevention within one health framework
https://pmc.ncbi.nlm.nih.gov/articles/PMC9871788/
Rising public concern over MRSA has led to monitoring recommendations, such as information on the prevalence of the infection in healthy dogs, cats, and humans. […] The prevalence of LA-MRSA from different studies also noted higher from different countries as mentioned in Table 1. Recent studies conducted in Pakistan detected 15.6% LA-MRSA from goat milk, 24.5% from cow milk, 30.4% from cats, and 33.9% from dogs. […] Transmission of MRSA among different hosts is primarily known to happen by physical contact with source. […] The capability of transfer of MRSA among different host species including humans and animals is the characteristic feature of MRSA lineages. […] HA-MRSA is primarily acquired from hospital settings such as contaminated instruments, bedding, doors, and equipments while CA-MRSA is primarily acquired by physical contact with infected or healthy person as S. aureus is a commensal bacterial in the nares of healthy individuals.
#27 MRSA – Epidemiology
https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/methicillin-resistant-staphylococcus-aureus-mrsa/
Anyone can get MRSA, but some groups have a higher risk. These groups include athletes, daycare and school students, military personnel in barracks, people who receive inpatient medical care, people who have surgery or medical devices inserted in their body, and people who inject drugs. […] Staph bacteria (including MRSA) are spread through contact with infected people, wounds, or things that have touched infected skin and are carrying the bacteria (e.g., towels, razors, athletic mats). […] If the bacteria are resistant to certain antibiotics, a diagnosis of MRSA is made. […] While MRSA can be resistant to several antibiotics, there are antibiotics available to treat MRSA infections. […] Except in special circumstances, treatment is not needed for people who carry MRSA but do not have any symptoms. […] If you are a patient or visitor in a healthcare facility, more strategies for preventing MRSA are available on the CDC website at cdc.gov/mrsa/hcp/infection-control/index.html.
#28 NC DPH: MRSA
https://epi.dph.ncdhhs.gov/CD/diseases/mrsa.html
MRSA (Methicillin-Resistant Staphylococcus aureus) […] MRSA may be spread from a person with an MRSA infection to another person, most often through direct physical contact such as contact with a draining lesion. […] Outbreaks of MRSA have occurred in healthcare settings, homes, prisons, daycare centers, on sports teams, and in other settings where people have close contact or share equipment and personal items. […] In healthcare settings (such as hospitals and nursing homes), MRSA can cause more severe or even life-threatening infections, such as bloodstream infections, joint infections and pneumonia. […] MRSA can be passed from one person to another through contaminated surfaces such as bed rails, bathroom fixtures, medical equipment and linens. […] Individuals most likely to get MRSA infections in a healthcare setting are those who have other health issues, and those who have prolonged stays in a hospital or long-term care facility.
#29 MRSA compendium of epidemiology, transmission, pathophysiology, treatment, and prevention within one health framework
https://pmc.ncbi.nlm.nih.gov/articles/PMC9871788/
LA-MRSA transmission to humans when the individual has physical contact with animal and environment. […] The risk of getting MRSA in animal caretakers (1.7%) was higher compared to those who were not exposed to animals. […] The major steps in pathogenesis of infection are colonization, virulence, initiation of infection, abscess formation, systemic infection, regulation and adaptation with the help of number of virulence factors. […] As MRSA is the methicillin-resistant strain of S. aureus, the S. aureus by self-contain a number of potential virulence factors which includes several surface proteins called microbial surface components recognizing adhesive matrix molecules (MSCRAMMs), which bind to fibrinogen, fibronectin, and collagen fibers of host cells to attack the host tissues. […] The ability of S. aureus to produce biofilm on both prosthetic surfaces and the host allows it to adhere to those surfaces by evading the effect of antimicrobials and host immune system.
#30 MRSA compendium of epidemiology, transmission, pathophysiology, treatment, and prevention within one health framework
https://pmc.ncbi.nlm.nih.gov/articles/PMC9871788/
Rising public concern over MRSA has led to monitoring recommendations, such as information on the prevalence of the infection in healthy dogs, cats, and humans. […] The prevalence of LA-MRSA from different studies also noted higher from different countries as mentioned in Table 1. Recent studies conducted in Pakistan detected 15.6% LA-MRSA from goat milk, 24.5% from cow milk, 30.4% from cats, and 33.9% from dogs. […] Transmission of MRSA among different hosts is primarily known to happen by physical contact with source. […] The capability of transfer of MRSA among different host species including humans and animals is the characteristic feature of MRSA lineages. […] HA-MRSA is primarily acquired from hospital settings such as contaminated instruments, bedding, doors, and equipments while CA-MRSA is primarily acquired by physical contact with infected or healthy person as S. aureus is a commensal bacterial in the nares of healthy individuals.
#31 MRSA compendium of epidemiology, transmission, pathophysiology, treatment, and prevention within one health framework
https://pmc.ncbi.nlm.nih.gov/articles/PMC9871788/
LA-MRSA transmission to humans when the individual has physical contact with animal and environment. […] The risk of getting MRSA in animal caretakers (1.7%) was higher compared to those who were not exposed to animals. […] The major steps in pathogenesis of infection are colonization, virulence, initiation of infection, abscess formation, systemic infection, regulation and adaptation with the help of number of virulence factors. […] As MRSA is the methicillin-resistant strain of S. aureus, the S. aureus by self-contain a number of potential virulence factors which includes several surface proteins called microbial surface components recognizing adhesive matrix molecules (MSCRAMMs), which bind to fibrinogen, fibronectin, and collagen fibers of host cells to attack the host tissues. […] The ability of S. aureus to produce biofilm on both prosthetic surfaces and the host allows it to adhere to those surfaces by evading the effect of antimicrobials and host immune system.
#32 MRSA compendium of epidemiology, transmission, pathophysiology, treatment, and prevention within one health framework
https://pmc.ncbi.nlm.nih.gov/articles/PMC9871788/
However, the existence of some virulence factors is independent of the genomic structure and are related to clonal type. […] Methicillin resistant strain of S. aureus (MRSA) is an emerging pathogen that can cause mild to serious infections in both animals and humans. […] Among humans, it mostly causes mild to life deadly infections such as skin and soft tissue infections which are staphylococcal scalded skin syndrome (SSSS), pustules, impetigo contagiosa, abscesses, and papules while deadly infections include TSS, pneumonia, or newborn TSS-like exanthematous disease in humans. […] Among the 100,000 cases of MRSA infections per year, 20% of the patients died. […] The emergence of LA-MRSA and its transmission to humans and reports of humans strains in animals further increases the pathogenicity of MRSA as now MRSA have diversity of host species which results in genomic modification and increases the antibiotic resistance. […] The development of novel ways to combat antibiotic resistance and production of vaccine very important in this era.
#33 SciELO Brazil – Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America
https://www.scielo.br/j/bjid/a/XZKMpn6rnHnpSgNwfDPZdFg/
Surveillance systems monitoring the spread and divergence of methicillin-resistant Staphylococcus aureus (MRSA) strains are critical if preventive and therapeutic measures targeting MRSA infection are to be employed optimally. Surveillance provides information on the spread of MRSA, on the emergence of new strains within hospitals and communities, on the antibiotic resistance profile and virulence of strains, and on the risk factors associated with infection. […] While information on MRSA epidemiology in Latin America is growing, significant gaps exist in the available data, especially in local areas where fewer resources are available for characterizing and reporting MRSA strains. Here, we describe current knowledge of healthcare- and community-associated MRSA epidemiology in the region, and provide recommendations for future development of surveillance systems with a view to providing robust data at regional, national and local levels.
#34 SciELO Brazil – Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America
https://www.scielo.br/j/bjid/a/XZKMpn6rnHnpSgNwfDPZdFg/
Surveillance systems monitoring the spread and divergence of methicillin-resistant Staphylococcus aureus (MRSA) strains are critical if preventive and therapeutic measures targeting MRSA infection are to be employed optimally. Surveillance provides information on the spread of MRSA, on the emergence of new strains within hospitals and communities, on the antibiotic resistance profile and virulence of strains, and on the risk factors associated with infection. […] While information on MRSA epidemiology in Latin America is growing, significant gaps exist in the available data, especially in local areas where fewer resources are available for characterizing and reporting MRSA strains. Here, we describe current knowledge of healthcare- and community-associated MRSA epidemiology in the region, and provide recommendations for future development of surveillance systems with a view to providing robust data at regional, national and local levels.
#35 Invasive Staphylococcus aureus Infection Surveillance | HAIs | CDC
https://www.cdc.gov/healthcare-associated-infections/php/haic-eip/invasive-staphylococcus.html
The Invasive Staphylococcus aureus Infection Surveillance Program collects data for describing incidence and trends of these infections. […] Changes in incidence of hospital-onset (HO), healthcare-associated community-onset (HACO), and community-associated (CA) invasive, methicillin-resistant and methicillin-sensitive S. aureus (MRSA and MSSA) infections. […] Public health professionals and healthcare administrators can use these data to further research and improve S. aureus prevention strategies. […] HO MRSA incidence increased compared to 2017-2019. HACO and CA MRSA incidence decreased, interrupting the previous increases since 2017. […] The invasive S. aureus infection surveillance program is an active population- and laboratory-based surveillance system. Surveillance staff regularly query clinical laboratories to identify microbiological test results among persons living in a defined geographic area.
#36 MRSA Surveillance and the Emerging Infections Program
https://www.health.ny.gov/diseases/communicable/staphylococcus_aureus/methicillin_resistant/surveillance/emerging_infections_program.htm
New York State became a Centers for Disease Control and Prevention (CDC) Emerging Infections Program (EIP) site in 1997. Active, population-based surveillance for invasive disease due to methicillin-resistant Staphylococcus aureus (MRSA) is part of the Active Bacterial Core surveillance (ABCs) component of the Emerging Infections Program. Currently, 10 states participate in the Emerging Infections Program. […] Objectives of MRSA surveillance conducted by Emerging Infections Program sites are: To monitor the incidence and epidemiologic characteristics of healthcare-associated and community-associated invasive MRSA. To determine the molecular epidemiologic patterns of healthcare-associated and community-associated MRSA. […] The NYS Emerging Infections Program conducts invasive MRSA surveillance in Monroe County in collaboration with the University of Rochester. Some of the findings of MRSA surveillance in Monroe County are as follows: From April 2004 July 2007, 1,277 cases of invasive MRSA infections occurred. 5% of the cases were classified as community-associated MRSA (CA-MRSA) 95% of the cases were classified as health care-associated MRSA (HA-MRSA) Rates of CA-MRSA and HA-MRSA are increasing: CA-MRSA rates increased from 1.5 cases per 100,000 persons in 2005 to 4.6 cases per 100,000 persons in 2006. HA-MRSA rates increased from 40 cases per 100,000 persons in 2005 to 55 cases per 100,000 persons in 2006.
#37 The Epidemiology of Methicillin-Resistant Staphylococcus aureus (MRSA) in Germany (11.11.2011)
https://di.aerzteblatt.de/int/archive/article/112581
Data from the European Antimicrobial Resistance Surveillance Network (EARS-Net) indicate that the proportion of MRSA among all S. aureus isolates from blood cultures in Germany has substantially increased in the 1990s and has now remained stable at 16-20% for several years. […] Current data from the Robert Koch Institutes (RKI) interactive Antibiotics Resistance Surveillance Database also indicate a relatively stable percentage of MRSA cases (all S. aureus isolates obtained from inpatients) for 2008 and 2009: 19.2% (2008) and 21.9% (2009). […] A new data source on the number of invasive infections appeared in 2009, with the introduction of compulsory reporting by laboratories (according to Article 7 of the German Infection Protection Act) of MRSA detected in blood cultures and cerebrospinal fluid (CSF).
#38
https://www.who.int/data/gho/data/indicators/indicator-details/GHO/sdg-3.d.2-amr-infect-mrsa
Proportion of bloodstream infection due to methicillin-resistant Staphylococcus aureus (MRSA) (%) […] Rationale: Antimicrobial resistance (AMR) is a global threat to health, livelihoods, food security and the achievement of many of the Sustainable Development Goals. […] both MRSA and E. coli resistant to third-generation cephalosporins are largely disseminated and found in high frequency in human infections observed in hospital settings all over the world and increasingly very frequent in the community. […] Definition: Proportion of bloodstream infection due to methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli resistant to third-generation cephalosporins (e.g., ESBL- E. coli) among patients seeking care and whose blood sample is taken and tested. […] Method of measurement The WHO Global AMR Surveillance System (GLASS) supports countries to implement an AMR standardized surveillance system. […] GLASS does collect information on the origin of the infection, either community origin (less than 2 calendar days in hospital) or hospital origin (patients hospitalized for more than 2 calendar days). […] Limitations: AMR is an emerging global threat and risk to public health worldwide. […] It is imperative that countries should have a functioning national system to support AMR surveillance and report to GLASS.
#39 Proportion of bloodstream infection due to methicillin-resistant Staphylococcus aureus (MRSA) (%)
https://data.who.int/indicators/i/918081E/5DD9606
AMR is an emerging global threat and risk to public health worldwide. […] AMR surveillance, country preparedness and response are now high priority for WHO and its Member States. […] The WHO Global AMR Surveillance System (GLASS) supports countries to implement an AMR standardized surveillance system. […] Data is collated and validated at national level and reported to GLASS where epidemiological statistics and metrics are generated.
#40 Methicillin Resistant Staphylococcus aureus (MRSA) | Public Health Ontario
https://www.publichealthontario.ca/en/Diseases-and-Conditions/Health-Care-Associated-Infections/MRSA
MRSA infections most commonly occur in hospitals and other health care settings, especially among immunocompromised patients. […] Following correct infection prevention and control practices can help limit the spread of MRSA. […] Canadian Nosocomial Infections Surveillance Program – Public Health Agency of Canada.
#41 Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) in California Hospitals – Dataset – California Open Data
https://data.ca.gov/dataset/methicillin-resistant-staphylococcus-aureus-mrsa-bloodstream-infections-bsi-in-california-hospi
California Health and Safety Code section 1288.55(a)(1) requires general acute care hospitals to report all cases of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) identified in their facilities to the California Department of Public Health (CDPH). MRSA BSI data are submitted by hospitals to the Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN). […] CDPH downloads California hospital MRSA BSI data from NHSN and analyzes the data to describe prevention progress in an annual public report of healthcare-associated infections. CDPH publishes annual MRSA BSI data reported by each California hospital in the datasets below. […] The observed (reported) number of MRSA BSI are then compared to the predicted number of MRSA BSI in a ratio called the Standardized Infection Ratio or SIR. The SIR is a metric that summarizes an individual hospitals MRSA BSI prevention progress compared with the national baseline and California state-specific prevention goals. […] For general information about NHSN, surveillance definitions, and reporting requirements for MRSA BSI, please visit: https://www.cdc.gov/nhsn/index.html.
#42 The Epidemiology of Methicillin-Resistant Staphylococcus aureus (MRSA) in Germany (11.11.2011)
https://di.aerzteblatt.de/int/archive/article/112581
Data from the European Antimicrobial Resistance Surveillance Network (EARS-Net) indicate that the proportion of MRSA among all S. aureus isolates from blood cultures in Germany has substantially increased in the 1990s and has now remained stable at 16-20% for several years. […] Current data from the Robert Koch Institutes (RKI) interactive Antibiotics Resistance Surveillance Database also indicate a relatively stable percentage of MRSA cases (all S. aureus isolates obtained from inpatients) for 2008 and 2009: 19.2% (2008) and 21.9% (2009). […] A new data source on the number of invasive infections appeared in 2009, with the introduction of compulsory reporting by laboratories (according to Article 7 of the German Infection Protection Act) of MRSA detected in blood cultures and cerebrospinal fluid (CSF).
#43 Molecular characterization of MRSA collected during national surveillance between 2008 and 2019 in the Netherlands | Communications Medicine
https://www.nature.com/articles/s43856-023-00348-z
Although the Netherlands is a country with a low endemic level, methicillin-resistant Staphylococcus aureus (MRSA) poses a significant health care problem. Therefore, high coverage national MRSA surveillance has been in place since 1989. […] The Dutch national MRSA surveillance, in which all medical microbiology laboratories (MMLs) in the Netherlands send MRSA isolates to the National Institute for Public Health and the Environment (RIVM) for characterization, was started in 1989. The Dutch health inspectorate has urged the MMLs to submit MRSA isolates from all patients, and as a result, the coverage of the surveillance is high. […] The study reveals changes in the frequency in which MRSA lineages were found, distinct resistance and virulence gene profiles among the lineages, and reports on an increasing prevalence of MRSA isolates carrying genes encoding for Panton-Valentine Leukocidin (PVL), including LA-MRSA.
#44 MRSA Surveillance | Agency for Healthcare Research and Quality
https://www.ahrq.gov/hai/tools/mrsa-prevention/surgery/mrsa-surveillance.html
Methicillin-resistant Staphylococcus aureus (MRSA) surveillance can help prevent surgical site infections (SSIs) in two ways. First, it identifies the patients who are already colonized or infected with MRSA. With this information, you will know which patients need to be decolonized, if you are using a targeted decolonization technique. You are also able to tell which patients have a higher risk of a MRSA SSI and to use antimicrobial prophylaxis strategies targeted at preventing MRSA infections. […] This one-page document reviews the importance of MRSA surveillance in the perioperative setting. […] Describe active and passive approaches for MRSA surveillance. […] Understand the pros and cons of different MRSA surveillance approaches. […] Outline how to use MRSA surveillance data to inform MRSA prevention approaches and optimize antimicrobial prophylaxis selection.
#45 Active Surveillance for Methicillin-Resistant Staphylococcus aureus(MRSA) Decreases the Incidence of MRSA Bacteremia | Infection Control & Hospital Epidemiology | Cambridge Core
https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/active-surveillance-for-methicillinresistant-staphylococcus-aureusmrsa-decreases-the-incidence-of-mrsa-bacteremia/4BF2272A626F58952E571FEACE0F2512
Objectives. To evaluate the influence of performance of active surveillance cultures for methicillin-resistant Staphylococcus aureus (MRSA) on the incidence of nosocomial MRSA bacteremia in an endemic hospital. […] Results. The number of surveillance cultures performed increased from a mean of 272.57 cultures/month before the intervention to 865.83 cultures/month after the intervention. The percentage of surveillance cultures with positive results increased from 3.13% before to 5.22% after the intervention (P.001). The mean number of MRSA bacteremia cases per month decreased from 3.6 cases before the intervention to 1.8 cases after the intervention (P 0.001). […] Conclusions. Active surveillance culture is important for identifying hidden reservoirs of MRSA. Contact isolation can prevent new colonization and infection and lead to a significant reduction of morbidity and healthcare costs.
#46 Active Surveillance for Methicillin-Resistant Staphylococcus aureus(MRSA) Decreases the Incidence of MRSA Bacteremia | Infection Control & Hospital Epidemiology | Cambridge Core
https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/active-surveillance-for-methicillinresistant-staphylococcus-aureusmrsa-decreases-the-incidence-of-mrsa-bacteremia/4BF2272A626F58952E571FEACE0F2512
Objectives. To evaluate the influence of performance of active surveillance cultures for methicillin-resistant Staphylococcus aureus (MRSA) on the incidence of nosocomial MRSA bacteremia in an endemic hospital. […] Results. The number of surveillance cultures performed increased from a mean of 272.57 cultures/month before the intervention to 865.83 cultures/month after the intervention. The percentage of surveillance cultures with positive results increased from 3.13% before to 5.22% after the intervention (P.001). The mean number of MRSA bacteremia cases per month decreased from 3.6 cases before the intervention to 1.8 cases after the intervention (P 0.001). […] Conclusions. Active surveillance culture is important for identifying hidden reservoirs of MRSA. Contact isolation can prevent new colonization and infection and lead to a significant reduction of morbidity and healthcare costs.
#47 Prevalence of MRSA in ICU Patients After State-Mandated Surveillance – Infectious Disease Advisor
https://www.infectiousdiseaseadvisor.com/news/prevalence-of-mrsa-in-icu-patients-after-state-mandated-surveillance/
The prevalence of methicillin-resistant Staphylococcus aureus colonization did not decline after implementation of state-legislated active surveillance among critically ill adults. […] The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) among intensive care unit (ICU) patients in Illinois did not decline after legislatively mandated MRSA surveillance, according to a report published in Clinical Infectious Diseases. […] The prevalence of MRSA infection in Chicago’s ICU patients was analyzed in the 5 years after legislation to determine its effectiveness in reducing the spread of MRSA. […] A total of 3909 ICU patients were screened, with 432 (11.1%) found to be colonized with MRSA (95% CI, 10.1%-12.0%). The prevalence of MRSA colonization also remained consistent throughout the study period (year-over-year relative risk, 0.97; 95% CI, 0.89-1.05; P =.48).
#48 Prevalence of MRSA in ICU Patients After State-Mandated Surveillance – Infectious Disease Advisor
https://www.infectiousdiseaseadvisor.com/news/prevalence-of-mrsa-in-icu-patients-after-state-mandated-surveillance/
Mandatory legislation did not lead to a drop in MRSA prevalence. […] The investigators did note that MRSA prevalence was assessed in a region where it is widely endemic, so results may not be widely applicable to regions with lower MRSA rates. […] Nonetheless, the study identified some barriers to prompt use of contact precautions despite mandatory surveillance. […] Evidence exists that a universal decolonization approach (nasal mupirocin plus chlorhexidine gluconate bathing for all ICU patients, with discontinuation of MRSA active surveillance) is superior, but according to investigators, the current law does not allow hospitals to cease mandatory screening and adopt the more effective approach, suggesting a reevaluation of the mandatory active MRSA surveillance legislation is needed.
#49 SciELO Brazil – Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America
https://www.scielo.br/j/bjid/a/XZKMpn6rnHnpSgNwfDPZdFg/
The success of standardized surveillance in countries and regions depends on correct diagnosis of MRSA and identification of specific antimicrobial resistance patterns. […] An important aspect of developing successful surveillance systems is the appropriate training of personnel, from microbiologists involved in monitoring MRSA to clinicians providing patient care. […] In summary, surveillance is an important tool that assists in the implementation of different preventive and therapeutic measures to combat MRSA infections in the community and in hospitals.
#50 SciELO Brazil – Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America
https://www.scielo.br/j/bjid/a/XZKMpn6rnHnpSgNwfDPZdFg/
The success of standardized surveillance in countries and regions depends on correct diagnosis of MRSA and identification of specific antimicrobial resistance patterns. […] An important aspect of developing successful surveillance systems is the appropriate training of personnel, from microbiologists involved in monitoring MRSA to clinicians providing patient care. […] In summary, surveillance is an important tool that assists in the implementation of different preventive and therapeutic measures to combat MRSA infections in the community and in hospitals.
#51 Eurosurveillance | Prospective genomic surveillance of methicillin-resistant Staphylococcus aureus (MRSA) associated with bloodstream infection, England, 1 October 2012 to 30 September 2013
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2019.24.4.1800215
Mandatory reporting of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) has occurred in England for over 15 years. […] Ongoing developments in whole-genome sequencing (WGS) have demonstrated its value in outbreak investigations and for determining the spread of antimicrobial resistance and bacterial population structure. […] We conducted an epidemiological and genomic survey of MRSA BSI in England over a 1-year period (1 October 2012 to 30 September 2013). […] During the study period, 903 cases of MRSA BSI were reported; 425 isolates were available for sequencing of which, 276 (65%) were clonal complex (CC) 22. […] We demonstrate the potential utility of combined epidemiological and genomic MRSA BSI surveillance to determine the national population structure of MRSA, contextualise previous MRSA outbreaks, and detect potentially high-risk lineages. […] These findings support the integration of epidemiological and genomic surveillance for MRSA BSI as a step towards a comprehensive surveillance programme in England.
#52 Eurosurveillance | Prospective genomic surveillance of methicillin-resistant Staphylococcus aureus (MRSA) associated with bloodstream infection, England, 1 October 2012 to 30 September 2013
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2019.24.4.1800215
Mandatory reporting of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) has occurred in England for over 15 years. […] Ongoing developments in whole-genome sequencing (WGS) have demonstrated its value in outbreak investigations and for determining the spread of antimicrobial resistance and bacterial population structure. […] We conducted an epidemiological and genomic survey of MRSA BSI in England over a 1-year period (1 October 2012 to 30 September 2013). […] During the study period, 903 cases of MRSA BSI were reported; 425 isolates were available for sequencing of which, 276 (65%) were clonal complex (CC) 22. […] We demonstrate the potential utility of combined epidemiological and genomic MRSA BSI surveillance to determine the national population structure of MRSA, contextualise previous MRSA outbreaks, and detect potentially high-risk lineages. […] These findings support the integration of epidemiological and genomic surveillance for MRSA BSI as a step towards a comprehensive surveillance programme in England.
#53 Use of Genomic Surveillance Helps Identify Hidden MRSA Outbreak
https://www.contagionlive.com/view/use-of-genomic-surveillance-helps-identify-hidden-mrsa-outbreak
A total of 93% of the isolates from Brooklyn community patients were clustered within a unique clade of MRSA and consistent with that of the clone. […] Overall, the use of genomic sequencing to identify the unique USA300 clone of CA-MRSA spreading through the Orthodox Jewish community in Brooklyn identified not only an at-risk population, but a new strategy for identifying community outbreaks with methods typically used for hospital outbreak investigation. […] Genomic surveillance is commonly used to identify health care outbreaks and identify a source, but its application for community infection surveillance and control has great potential. […] As this study has shown, the use of genomic surveillance can help uncover outbreak and pathogenic reservoirs that might be ignored or undetected.
#54 Use of Genomic Surveillance Helps Identify Hidden MRSA Outbreak
https://www.contagionlive.com/view/use-of-genomic-surveillance-helps-identify-hidden-mrsa-outbreak
A total of 93% of the isolates from Brooklyn community patients were clustered within a unique clade of MRSA and consistent with that of the clone. […] Overall, the use of genomic sequencing to identify the unique USA300 clone of CA-MRSA spreading through the Orthodox Jewish community in Brooklyn identified not only an at-risk population, but a new strategy for identifying community outbreaks with methods typically used for hospital outbreak investigation. […] Genomic surveillance is commonly used to identify health care outbreaks and identify a source, but its application for community infection surveillance and control has great potential. […] As this study has shown, the use of genomic surveillance can help uncover outbreak and pathogenic reservoirs that might be ignored or undetected.
#55 SciELO Brazil – Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America
https://www.scielo.br/j/bjid/a/XZKMpn6rnHnpSgNwfDPZdFg/
The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) is constantly changing, and both circulating clones and their antibiotic resistance profiles vary considerably throughout regions and countries. […] Therefore, epidemiologic information gathered through ongoing surveillance is essential to support clinicians and infection control committees in their efforts to prevent and treat infection. […] Regular surveillance for MRSA in hospital settings in the USA and Europe has been organized since the late 1980s and early 1990s. […] In Latin America, awareness of the dangers posed by growing antimicrobial resistance motivated the first meeting of the Pan-American Conference on Antimicrobial Resistance in 1998 in Caraballeda, Venezuela. […] Data quality is a central consideration in developing a reliable surveillance system for MRSA, and individual surveillance centers across Latin America are admitted to the network based on meeting appropriate levels of quality control, standardization and regular data reporting.
#56 New Guidance to Stem the Tide of MRSA Spread in Hospitals | MedPage Today
https://www.medpagetoday.com/hospitalbasedmedicine/infectioncontrol/105256
During the COVID pandemic, methicillin-resistant Staphylococcus aureus (MRSA) infections in acute care hospitals rose steeply, despite a decrease of infections before the pandemic, the Society for Healthcare Epidemiology of America (SHEA) said in its latest guidelines. […] About 10% of infections in U.S. hospitals are due to MRSA, the authors said. During the first year of the pandemic, progress against deadly antimicrobial-resistant infections reversed course, according to data from the CDC. […] In the updated guidelines, Calfee and co-authors recommended active surveillance to detect asymptomatic MRSA, particularly among certain vulnerable patient populations, noting that patients should be assessed on a continual basis, especially if hospital precautions have been modified, or are in the process of being modified.
#57 Infection Control in the ICU: MRSA Control | SpringerLink
https://link.springer.com/10.1007/978-3-642-00418-6_62
MRSA is an important nosocomial pathogen in terms of its virulence and survival fitness. In acute care facilities, there is selective advantage for MRSA survival as a result of antibiotic use and selection pressure. Multidrug-resistant pathogens, including MRSA, are being isolated at increased frequency in intensive care units (ICUs). National surveillance data has shown that MRSA is recovered in greater than 60% of S. aureus isolates from US intensive care units (ICUs) and 24% of isolates from German ICUs. […] The use of active surveillance cultures in adult intensive care units to reduce methicillin-resistant Staphylococcus aureus-related morbidity, mortality, and costs: a systematic review. […] Strategies to prevent transmission of methicillin-resistant Staphylococcus aureus in acute care hospitals.
#58 The Epidemiology of Methicillin-Resistant Staphylococcus aureus (MRSA) in Germany (11.11.2011)
https://di.aerzteblatt.de/int/archive/article/112581
For decades, methicillin-resistant Staphylococcus aureus (MRSA) has been a major cause of infection in hospitals and nursing homes (health care-associated MRSA, HA-MRSA). […] There are about 132 000 cases of MRSA in German hospitals each year. MRSA is found in about 18% to 20% of all inpatient-derived culture specimens that are positive for S. aureus. […] Hospitals and nursing homes were once the main reservoirs of MRSA, but new ones have now emerged outside of the healthcare setting. […] Estimates indicate that there are approximately 170 000 MRSA infections in European healthcare systems each year, causing more than 5000 fatalities, more than 1 million additional inpatient days, and additional costs of approximately 380 million. […] In terms of its incidence rate (the number of cases per 1000 patient days), MRSA remains the most common multidrug-resistant pathogen causing nosocomial infections in Germany.
#59 Infection Control in the ICU: MRSA Control | SpringerLink
https://link.springer.com/10.1007/978-3-642-00418-6_62
MRSA is an important nosocomial pathogen in terms of its virulence and survival fitness. In acute care facilities, there is selective advantage for MRSA survival as a result of antibiotic use and selection pressure. Multidrug-resistant pathogens, including MRSA, are being isolated at increased frequency in intensive care units (ICUs). National surveillance data has shown that MRSA is recovered in greater than 60% of S. aureus isolates from US intensive care units (ICUs) and 24% of isolates from German ICUs. […] The use of active surveillance cultures in adult intensive care units to reduce methicillin-resistant Staphylococcus aureus-related morbidity, mortality, and costs: a systematic review. […] Strategies to prevent transmission of methicillin-resistant Staphylococcus aureus in acute care hospitals.
#60 Methicillin-Resistant Staphylococcus aureus (MRSA) Bloodstream Infections: Surveillance, 2015-2016 | Institut national de santÃ© publique du QuÃ©bec
https://www.inspq.qc.ca/en/nosocomial-infections/spin-mrsa/surveillance-results-2015-2016
In total, 258 cases of MRSA bloodstream infections were reported, of which 111 (43.0%) were healthcare-associated. Catheter-related primary bloodstream infection represented the most frequently reported type of infection (24.1%). In 2015-2016, primary bloodstream infection represented 51.7% of the overall HA-MRSA-BSI. A total of 23 deaths were observed among the 87 HA-MRSA-BSI, yielding a 30 days case fatality of 26.4%. […] The proportion of methicillin resistance in healthcare-associated bloodstream infections due to S. aureus decreased gradually from 2010-2011 to reach 12.6% in 2015-2016.
#61 Epidemiology and risk factors for mortality among methicillin-resistant Staphylococcus aureus bacteremic patients in Southern Brazil | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0283774
This study aimed to evaluate the epidemiology and 30-day mortality of adult patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. We retrospectively reviewed the demographic and clinical data of adult patients with S. aureus bloodstream infections (BSI), admitted to a tertiary public teaching medical center in Porto Alegre, Southern Brazil, from January 2014 to December 2019. A total of 928 patients with S. aureus BSI were identified in the study period (68.5 per 100,000 patient-years), and the proportion of MRSA isolates was 22% (1927%). Thus, 199 patients were included in the analyses. […] Methicillin-resistant S. aureus (MRSA) is challenging in terms of therapeutic strategies, and the occurrence of bacteremia is associated with metastatic infections, recurrence, and high mortality rates (ranging from 15% to 40%). MRSA has a global prevalence ranging from less than 5% to over 80%, being a prominent burden in many countries.
#62
https://jidc.org/index.php/journal/article/view/31940297
Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) infections remain prevalent and are associated with significant morbidity and mortality. The aim of the present study was to investigate the epidemiology of MRSA infections and antibiotic susceptibility in Qatif, Saudi Arabia. […] A total of 3395 patients with S. aureus infections were analyzed, with an overall annual MRSA incidence of 25 cases per 100,000 patients (27% of total S. aureus isolates). While the majority (64%) of MRSA infections occurred in healthcare setting, CA-MRSA isolation increased steadily from 23% in 2006 to 60% in 2015, exceeding rate of isolation of healthcare-associated (HA)-MRSA. […] Staphylococcus aureus continues to cause multiple site infections with a relatively stable methicillin-resistance rate, but the isolation of MRSA from the community is increasing.
#63
https://jidc.org/index.php/journal/article/view/31940297
Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) infections remain prevalent and are associated with significant morbidity and mortality. The aim of the present study was to investigate the epidemiology of MRSA infections and antibiotic susceptibility in Qatif, Saudi Arabia. […] A total of 3395 patients with S. aureus infections were analyzed, with an overall annual MRSA incidence of 25 cases per 100,000 patients (27% of total S. aureus isolates). While the majority (64%) of MRSA infections occurred in healthcare setting, CA-MRSA isolation increased steadily from 23% in 2006 to 60% in 2015, exceeding rate of isolation of healthcare-associated (HA)-MRSA. […] Staphylococcus aureus continues to cause multiple site infections with a relatively stable methicillin-resistance rate, but the isolation of MRSA from the community is increasing.
#64 Molecular characterization of MRSA collected during national surveillance between 2008 and 2019 in the Netherlands | Communications Medicine
https://www.nature.com/articles/s43856-023-00348-z
The proportion of PVL-positive isolates increasing from 15% in 2008-2010 to 25% in 2017-2019. […] The overall composition of the population remained similar, although some GGs, such as GG0001 and GG0022 isolates, were submitted considerably more frequently in recent years. […] The proportion of submitted PVL-positive isolates from 14% in 2008-2010 to 26% in 2017-2019. […] The geographic distribution of residential locations of persons in the Netherlands was similar for most GGs reflecting the population density, except for GG1045 and GG0398. […] The PVL-positive GG0398 isolates were predominantly found in the densely populated Western part of the Netherlands, where the number of pig farms is low.
#65 Insights from a decade of surveillance: Molecular epidemiology of methicillin-resistant Staphylococcus aureus in Norway from 2008 to 2017 | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0297333
Norway has a low prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and reporting of all MRSA cases has been mandatory, including infections and carriage, since 1995 and 2005 accordingly. This provides a unique window to study the spread of MRSA in Norway over time. […] During the study period, there were 15,200 MRSA cases reported in Norway, from 14,386 patients. The notification rate per 100,000 population increased by 15% annually, rising from 14.2 in 2007 to 48.6 in 2017. This increase was primarily driven by MRSA carriage and community-associated MRSA cases. The incidence of invasive infections remained stable and low, at less than 0.5. The incidence of healthcare-associated MRSA showed an increasing trend, while the number of outbreak-related cases, particularly those associated with nursing homes, decreased. Overall, there were significantly more MRSA infections in males than females. Interestingly, there was a significantly higher prevalence of MRSA infections in female young adolescents compared to males.
#66 Staphylococcus Aureus Infection: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/971358-overview
Both community-associated and hospital-acquired infections with Staphylococcus aureus have increased in the past 20 years, and the rise in incidence has been accompanied by a rise in antibiotic-resistant strains in particular, methicillin-resistant S aureus (MRSA) and, more recently, vancomycin-resistant strains. […] An analysis of laboratory-confirmed MRSA cases in the Active Bacterial Core Surveillance database (which covers 9 geographic regions and represents some 4.4 million children younger than 18 years of age) indicates that community-acquired invasive MRSA infection is increasing among children, particularly among Black children and infants younger than 90 days of age. The incidence of community-acquired MRSA increased from 1.1 case per 100,000 children in 2005 to 1.7 cases per 100,000 in 2010.
#67 Staphylococcus Aureus Infection: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/971358-overview
Both community-associated and hospital-acquired infections with Staphylococcus aureus have increased in the past 20 years, and the rise in incidence has been accompanied by a rise in antibiotic-resistant strains in particular, methicillin-resistant S aureus (MRSA) and, more recently, vancomycin-resistant strains. […] An analysis of laboratory-confirmed MRSA cases in the Active Bacterial Core Surveillance database (which covers 9 geographic regions and represents some 4.4 million children younger than 18 years of age) indicates that community-acquired invasive MRSA infection is increasing among children, particularly among Black children and infants younger than 90 days of age. The incidence of community-acquired MRSA increased from 1.1 case per 100,000 children in 2005 to 1.7 cases per 100,000 in 2010.
#68 New Guidance to Stem the Tide of MRSA Spread in Hospitals | MedPage Today
https://www.medpagetoday.com/hospitalbasedmedicine/infectioncontrol/105256
During the COVID pandemic, methicillin-resistant Staphylococcus aureus (MRSA) infections in acute care hospitals rose steeply, despite a decrease of infections before the pandemic, the Society for Healthcare Epidemiology of America (SHEA) said in its latest guidelines. […] About 10% of infections in U.S. hospitals are due to MRSA, the authors said. During the first year of the pandemic, progress against deadly antimicrobial-resistant infections reversed course, according to data from the CDC. […] In the updated guidelines, Calfee and co-authors recommended active surveillance to detect asymptomatic MRSA, particularly among certain vulnerable patient populations, noting that patients should be assessed on a continual basis, especially if hospital precautions have been modified, or are in the process of being modified.
#69 New Guidance to Stem the Tide of MRSA Spread in Hospitals | MedPage Today
https://www.medpagetoday.com/hospitalbasedmedicine/infectioncontrol/105256
During the COVID pandemic, methicillin-resistant Staphylococcus aureus (MRSA) infections in acute care hospitals rose steeply, despite a decrease of infections before the pandemic, the Society for Healthcare Epidemiology of America (SHEA) said in its latest guidelines. […] About 10% of infections in U.S. hospitals are due to MRSA, the authors said. During the first year of the pandemic, progress against deadly antimicrobial-resistant infections reversed course, according to data from the CDC. […] In the updated guidelines, Calfee and co-authors recommended active surveillance to detect asymptomatic MRSA, particularly among certain vulnerable patient populations, noting that patients should be assessed on a continual basis, especially if hospital precautions have been modified, or are in the process of being modified.
#70 Invasive Staphylococcus aureus Infection Surveillance | HAIs | CDC
https://www.cdc.gov/healthcare-associated-infections/php/haic-eip/invasive-staphylococcus.html
The Invasive Staphylococcus aureus Infection Surveillance Program collects data for describing incidence and trends of these infections. […] Changes in incidence of hospital-onset (HO), healthcare-associated community-onset (HACO), and community-associated (CA) invasive, methicillin-resistant and methicillin-sensitive S. aureus (MRSA and MSSA) infections. […] Public health professionals and healthcare administrators can use these data to further research and improve S. aureus prevention strategies. […] HO MRSA incidence increased compared to 2017-2019. HACO and CA MRSA incidence decreased, interrupting the previous increases since 2017. […] The invasive S. aureus infection surveillance program is an active population- and laboratory-based surveillance system. Surveillance staff regularly query clinical laboratories to identify microbiological test results among persons living in a defined geographic area.
#71 MRSA compendium of epidemiology, transmission, pathophysiology, treatment, and prevention within one health framework
https://pmc.ncbi.nlm.nih.gov/articles/PMC9871788/
This review is going to discuss various aspects of MRSA starting from emergence, transmission, epidemiology, pathophysiology, disease patterns in hosts, novel treatment, and control strategies. […] The global emergence and transmission of MRSA is one the most important aspect in the epidemiology of MRSA. The spread of all types of MRSA have been reported from many countries as listed in Table 1. […] According to the statement of CDC, MRSA is known to be a major threat to public health because of its increasing prevalence in hospitals, community and animals, transmission between humans and animals, infection rates, resistance, and therapeutic issues. […] On an average, it was estimated the annual health cost due to MRSA infections accounts 3 billion dollars. […] It is noted MRSA mostly causes skin and soft tissue infection leading to bacteremia which lead to higher mortality rates ranging from 15 to 60%.
#72 MRSA compendium of epidemiology, transmission, pathophysiology, treatment, and prevention within one health framework
https://pmc.ncbi.nlm.nih.gov/articles/PMC9871788/
However, the existence of some virulence factors is independent of the genomic structure and are related to clonal type. […] Methicillin resistant strain of S. aureus (MRSA) is an emerging pathogen that can cause mild to serious infections in both animals and humans. […] Among humans, it mostly causes mild to life deadly infections such as skin and soft tissue infections which are staphylococcal scalded skin syndrome (SSSS), pustules, impetigo contagiosa, abscesses, and papules while deadly infections include TSS, pneumonia, or newborn TSS-like exanthematous disease in humans. […] Among the 100,000 cases of MRSA infections per year, 20% of the patients died. […] The emergence of LA-MRSA and its transmission to humans and reports of humans strains in animals further increases the pathogenicity of MRSA as now MRSA have diversity of host species which results in genomic modification and increases the antibiotic resistance. […] The development of novel ways to combat antibiotic resistance and production of vaccine very important in this era.
#73 Methicillin-Resistant Staphylococcus aureus (MRSA) Bloodstream Infections: Surveillance, 2015-2016 | Institut national de santÃ© publique du QuÃ©bec
https://www.inspq.qc.ca/en/nosocomial-infections/spin-mrsa/surveillance-results-2015-2016
In total, 258 cases of MRSA bloodstream infections were reported, of which 111 (43.0%) were healthcare-associated. Catheter-related primary bloodstream infection represented the most frequently reported type of infection (24.1%). In 2015-2016, primary bloodstream infection represented 51.7% of the overall HA-MRSA-BSI. A total of 23 deaths were observed among the 87 HA-MRSA-BSI, yielding a 30 days case fatality of 26.4%. […] The proportion of methicillin resistance in healthcare-associated bloodstream infections due to S. aureus decreased gradually from 2010-2011 to reach 12.6% in 2015-2016.
#74 Surveillance for severe community-associated methicillin-resistant Staphylococcus aureus infection | Epidemiology & Infection | Cambridge Core
https://www.cambridge.org/core/journals/epidemiology-and-infection/article/surveillance-for-severe-communityassociated-methicillinresistant-staphylococcus-aureus-infection/76349CB83EB09C7E82152F109DC6A64F
The passive surveillance case definitions for CA-MRSA infections were developed in consultation with infection-control practitioners (ICPs). […] Severe CA-MRSA disease was defined as CA-MRSA infection associated with a sterile-site isolate (invasive disease), infection requiring intensive care or operative debridement, or infection resulting in death. […] The case-fatality ratio was 34% (56/1670) during the surveillance period. […] Invasive CA-MRSA and MRSA pneumonia remained risk factors for death when controlling for age and the presence of other clinical syndromes. […] Georgia’s severe CA-MRSA disease surveillance system documents severe illness and death resulting from this pathogen statewide. […] The actual prevalence of severe CA-MRSA disease is probably higher than reported.
#75 MRSA compendium of epidemiology, transmission, pathophysiology, treatment, and prevention within one health framework
https://pmc.ncbi.nlm.nih.gov/articles/PMC9871788/
This review is going to discuss various aspects of MRSA starting from emergence, transmission, epidemiology, pathophysiology, disease patterns in hosts, novel treatment, and control strategies. […] The global emergence and transmission of MRSA is one the most important aspect in the epidemiology of MRSA. The spread of all types of MRSA have been reported from many countries as listed in Table 1. […] According to the statement of CDC, MRSA is known to be a major threat to public health because of its increasing prevalence in hospitals, community and animals, transmission between humans and animals, infection rates, resistance, and therapeutic issues. […] On an average, it was estimated the annual health cost due to MRSA infections accounts 3 billion dollars. […] It is noted MRSA mostly causes skin and soft tissue infection leading to bacteremia which lead to higher mortality rates ranging from 15 to 60%.
#76 MRSA compendium of epidemiology, transmission, pathophysiology, treatment, and prevention within one health framework
https://pmc.ncbi.nlm.nih.gov/articles/PMC9871788/
This review is going to discuss various aspects of MRSA starting from emergence, transmission, epidemiology, pathophysiology, disease patterns in hosts, novel treatment, and control strategies. […] The global emergence and transmission of MRSA is one the most important aspect in the epidemiology of MRSA. The spread of all types of MRSA have been reported from many countries as listed in Table 1. […] According to the statement of CDC, MRSA is known to be a major threat to public health because of its increasing prevalence in hospitals, community and animals, transmission between humans and animals, infection rates, resistance, and therapeutic issues. […] On an average, it was estimated the annual health cost due to MRSA infections accounts 3 billion dollars. […] It is noted MRSA mostly causes skin and soft tissue infection leading to bacteremia which lead to higher mortality rates ranging from 15 to 60%.
#77 Methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus aureus (SA)
https://diagnostics.roche.com/be/en/article-listing/health-topics/infectious-diseases/mrsa.html
In the US alone, Staphylococcus aureus (SA) and methicillin-resistant Staphylococcus aureus (MRSA) infections burden the healthcare system with approximately $9.5 billion and $20 billion in annual care costs, respectively. […] The substantial human suffering and financial burden of these endemic infections prompt an urgent need for healthcare facilities to establish effective surveillance for infection control and prevention. […] To address the evolving problem of MRSA/SA, growing numbers of hospitals are partnering with microbiology labs to incorporate MRSA/SA screening and surveillance to identify and control these infections. […] Microbiology labs are the first lines of defence for detection of MRSA/SA unexpected outbreaks. By implementing a reliable surveillance program that rapidly and accurately detects colonised patients, clinical microbiology and infection control can help reduce the worldwide burden and spread of these costly infections.
#78 Azthena logo with the word Azthena
https://www.news-medical.net/news/20180523/Frequent-MRSA-surveillance-could-contain-infection-in-newborns-study-finds.aspx
The more often a hospital can check its newborns for deadly MRSA germs, the more likely it will be that they are contained, according to a new study. […] However, researchers noted that there are significant barriers to the frequency of this surveillance, including cost and available facilities. […] Incidences of infections in newborns rose 308 percent between 1995 and 2004, and each infection was associated with a patient spending an extra 40 days and $164,301 in the hospital. […] Compared to the monthly surveillance, the once-per-week checks were found to lower the number of infants colonized by MRSA by about 80 percent, from an average of 2.9 to 0.6. […] Additionally, the average duration of MRSA colonization went down from 307 hours to 61 hours, another 80 percent drop. […] The study stopped at one-week surveillance, but begs the question: Would even smaller intervals between surveillance be better?
#79 The Epidemiology of Methicillin-Resistant Staphylococcus aureus (MRSA) in Germany (11.11.2011)
https://di.aerzteblatt.de/int/archive/article/112581
For decades, methicillin-resistant Staphylococcus aureus (MRSA) has been a major cause of infection in hospitals and nursing homes (health care-associated MRSA, HA-MRSA). […] There are about 132 000 cases of MRSA in German hospitals each year. MRSA is found in about 18% to 20% of all inpatient-derived culture specimens that are positive for S. aureus. […] Hospitals and nursing homes were once the main reservoirs of MRSA, but new ones have now emerged outside of the healthcare setting. […] Estimates indicate that there are approximately 170 000 MRSA infections in European healthcare systems each year, causing more than 5000 fatalities, more than 1 million additional inpatient days, and additional costs of approximately 380 million. […] In terms of its incidence rate (the number of cases per 1000 patient days), MRSA remains the most common multidrug-resistant pathogen causing nosocomial infections in Germany.
#80 SciELO Brazil – Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America
https://www.scielo.br/j/bjid/a/XZKMpn6rnHnpSgNwfDPZdFg/
The success of standardized surveillance in countries and regions depends on correct diagnosis of MRSA and identification of specific antimicrobial resistance patterns. […] An important aspect of developing successful surveillance systems is the appropriate training of personnel, from microbiologists involved in monitoring MRSA to clinicians providing patient care. […] In summary, surveillance is an important tool that assists in the implementation of different preventive and therapeutic measures to combat MRSA infections in the community and in hospitals.
#81 SciELO Brazil – Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America
https://www.scielo.br/j/bjid/a/XZKMpn6rnHnpSgNwfDPZdFg/
Despite these efforts, resources for monitoring the changing epidemiology of MRSA remain limited, and the true nature and extent of MRSA infections in the region are not well understood. […] Wider-reaching and coordinated programs to provide regular surveillance reports are needed to support clinicians and infection control committees faced with the challenges of treating and preventing infections due to MRSA. […] Surveillance of MRSA infections is important in both healthcare and community settings due to the continuously changing epidemiologic profile of MRSA. […] The overall goal of surveillance in public health is to provide information to decrease morbidity and mortality, and to improve health. […] A surveillance system for MRSA could range from a simple system, in which data are collected from a single hospital, to a complex electronic system that receives and integrates data from multiple sources.
#82 Active Surveillance for Methicillin-Resistant Staphylococcus aureus(MRSA) Decreases the Incidence of MRSA Bacteremia | Infection Control & Hospital Epidemiology | Cambridge Core
https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/active-surveillance-for-methicillinresistant-staphylococcus-aureusmrsa-decreases-the-incidence-of-mrsa-bacteremia/4BF2272A626F58952E571FEACE0F2512
Objectives. To evaluate the influence of performance of active surveillance cultures for methicillin-resistant Staphylococcus aureus (MRSA) on the incidence of nosocomial MRSA bacteremia in an endemic hospital. […] Results. The number of surveillance cultures performed increased from a mean of 272.57 cultures/month before the intervention to 865.83 cultures/month after the intervention. The percentage of surveillance cultures with positive results increased from 3.13% before to 5.22% after the intervention (P.001). The mean number of MRSA bacteremia cases per month decreased from 3.6 cases before the intervention to 1.8 cases after the intervention (P 0.001). […] Conclusions. Active surveillance culture is important for identifying hidden reservoirs of MRSA. Contact isolation can prevent new colonization and infection and lead to a significant reduction of morbidity and healthcare costs.
#83 Insights from a decade of surveillance: Molecular epidemiology of methicillin-resistant Staphylococcus aureus in Norway from 2008 to 2017 | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0297333
This study highlights that Norway, while still classified as a low-prevalence country, has experienced a significant increase in the incidence of MRSA between 2008 and 2017, which can predominantly be attributed to CA-MRSA and MRSA carriage. […] From 2008 to 2017, there has been a notable rise in the incidence of MRSA in Norway. This increase can be primarily attributed to CA-MRSA and carriage, while the incidence of infections and invasive infections have remained relatively low. Overall, there were significantly more MRSA infections in males than females. Interestingly, there was a significantly higher prevalence of MRSA infections in female young adolescents compared to males. The incidence of HA-MRSA has also increased, although it is still below 10 per 100,000 population. This suggests that the Norwegian „search and destroy” policy has been effective in preventing MRSA from becoming endemic in Norwegian healthcare institutions. Global patterns of travel, migration and work have however had large impact on the MRSA epidemiology in Norway, highlighting the importance of national and international surveillance in order to monitor temporal trends and spread of successful clones.
#84 Azthena logo with the word Azthena
https://www.news-medical.net/news/20180523/Frequent-MRSA-surveillance-could-contain-infection-in-newborns-study-finds.aspx
The more often a hospital can check its newborns for deadly MRSA germs, the more likely it will be that they are contained, according to a new study. […] However, researchers noted that there are significant barriers to the frequency of this surveillance, including cost and available facilities. […] Incidences of infections in newborns rose 308 percent between 1995 and 2004, and each infection was associated with a patient spending an extra 40 days and $164,301 in the hospital. […] Compared to the monthly surveillance, the once-per-week checks were found to lower the number of infants colonized by MRSA by about 80 percent, from an average of 2.9 to 0.6. […] Additionally, the average duration of MRSA colonization went down from 307 hours to 61 hours, another 80 percent drop. […] The study stopped at one-week surveillance, but begs the question: Would even smaller intervals between surveillance be better?
#85 Methicillin-Resistant Staphylococcus aureus – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK482221/
Clinical suspicion in patients with risk factors related to MRSA infection is crucial in diagnostic and therapeutic intervention. Confirmation of MRSA infection should not delay treatment with empiric antibiotics against MRSA. […] The key to managing MRSA infections is to prevent them in the first place. Over the years many guidelines have been issued, and most hospitals have a team of infectious disease experts as part of the hospital interprofessional team who perform surveillance and monitor for outbreaks of MRSA.
#86 Methicillin-Resistant Staphylococcus aureus – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK482221/
Clinical suspicion in patients with risk factors related to MRSA infection is crucial in diagnostic and therapeutic intervention. Confirmation of MRSA infection should not delay treatment with empiric antibiotics against MRSA. […] The key to managing MRSA infections is to prevent them in the first place. Over the years many guidelines have been issued, and most hospitals have a team of infectious disease experts as part of the hospital interprofessional team who perform surveillance and monitor for outbreaks of MRSA.
#87 MRSA in Hospital Setting | IntechOpen
https://www.intechopen.com/chapters/88858
The incidence of MRSA infections in hospitals is influenced by several factors. The presence of MRSA carriers among patients and healthcare workers increases the likelihood of transmission. High patient turnover, overcrowding, and insufficient adherence to infection control practices contribute to the spread of MRSA within healthcare facilities. […] Preventing and controlling MRSA infections require a multifaceted approach. Hand hygiene is of the utmost importance and should be practiced rigorously by all healthcare workers, patients, and visitors. The use of personal protective equipment, such as gloves and gowns, can help to minimize the risk of transmission. Implementing contact precautions, including the isolation of infected or colonized patients, can further reduce the spread of MRSA. Active surveillance programs also play a crucial role in the identification of MRSA. It is recognized that infection prevention and control strategies are important to prevent and control transmission.
#88 MRSA infection – Symptoms & causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/mrsa/symptoms-causes/syc-20375336
MRSA infections can resist the effects of many common antibiotics, so they’re more difficult to treat. This can allow the infections to spread and sometimes become life-threatening. […] In the hospital, people who are infected or colonized with MRSA often are placed in isolation as a measure to prevent the spread of MRSA. […] Hospital rooms, surfaces and equipment, as well as laundry items, need to be properly disinfected and cleaned regularly. […] MRSA outbreaks have occurred in military training camps, child care centers and jails.
#89 MRSA infection – Symptoms & causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/mrsa/symptoms-causes/syc-20375336
MRSA infections can resist the effects of many common antibiotics, so they’re more difficult to treat. This can allow the infections to spread and sometimes become life-threatening. […] In the hospital, people who are infected or colonized with MRSA often are placed in isolation as a measure to prevent the spread of MRSA. […] Hospital rooms, surfaces and equipment, as well as laundry items, need to be properly disinfected and cleaned regularly. […] MRSA outbreaks have occurred in military training camps, child care centers and jails.
#90 Methicillin-resistant Staphylococcus aureus: an overview of basic and clinical research | Nature Reviews Microbiology
https://www.nature.com/articles/s41579-018-0147-4
One of the largest and most up-to-date cross-sectional studies on the burden of MRSA infections in US hospitals is presented. […] This up-to-date cross-sectional study confirms a reduction in the MRSA incidence among the US paediatric population, mirroring adult trends. […] This study demonstrates that the implementation of a MRSA bundle that couples active surveillance with contact precautions and hand hygiene results in decreased rates of health-care-associated MRSA infections. […] This study shows no added benefit for universal, rapid MRSA admission screening strategy on nosocomial MRSA infection rates in a surgical department. […] This large multicentre study shows that universal decolonization is more effective than targeted decolonization or screening and isolation in reducing rates of MRSA clinical isolates and bloodstream infection in patients in the ICU.
#91 Prevalence of MRSA in ICU Patients After State-Mandated Surveillance – Infectious Disease Advisor
https://www.infectiousdiseaseadvisor.com/news/prevalence-of-mrsa-in-icu-patients-after-state-mandated-surveillance/
Mandatory legislation did not lead to a drop in MRSA prevalence. […] The investigators did note that MRSA prevalence was assessed in a region where it is widely endemic, so results may not be widely applicable to regions with lower MRSA rates. […] Nonetheless, the study identified some barriers to prompt use of contact precautions despite mandatory surveillance. […] Evidence exists that a universal decolonization approach (nasal mupirocin plus chlorhexidine gluconate bathing for all ICU patients, with discontinuation of MRSA active surveillance) is superior, but according to investigators, the current law does not allow hospitals to cease mandatory screening and adopt the more effective approach, suggesting a reevaluation of the mandatory active MRSA surveillance legislation is needed.
#92 Azthena logo with the word Azthena
https://www.news-medical.net/news/20180523/Frequent-MRSA-surveillance-could-contain-infection-in-newborns-study-finds.aspx
Isolation rooms are used in NICUs to keep infected patients apart from others to reduce transmission. […] Over six months, the simulation showed that a weekly surveillance program would cost between $15,000 and $98,000, while a once-every-four-week program was estimated at $3,500 to $23,000, roughly four times less expensive. […] Hospitals will continue to face a tough balance between keeping newborns free of potentially harmful germs and making the bottom line work for staffing and resources. […] Goldstein hopes other institutions could run simulations similar to what he and his team did to more accurately reflect their own situations in the NICU. […] „An effective infection control program should not overly rely on any singular strategy,” he concluded.
#93 SciELO Brazil – Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America
https://www.scielo.br/j/bjid/a/XZKMpn6rnHnpSgNwfDPZdFg/
Despite these efforts, resources for monitoring the changing epidemiology of MRSA remain limited, and the true nature and extent of MRSA infections in the region are not well understood. […] Wider-reaching and coordinated programs to provide regular surveillance reports are needed to support clinicians and infection control committees faced with the challenges of treating and preventing infections due to MRSA. […] Surveillance of MRSA infections is important in both healthcare and community settings due to the continuously changing epidemiologic profile of MRSA. […] The overall goal of surveillance in public health is to provide information to decrease morbidity and mortality, and to improve health. […] A surveillance system for MRSA could range from a simple system, in which data are collected from a single hospital, to a complex electronic system that receives and integrates data from multiple sources.
#94
https://www.healio.com/news/infectious-disease/20220527/genomic-surveillance-uncovers-clusters-of-mrsa-causing-bloodstream-infections
In summary, transmission events leading to invasive, antibiotic-resistant infections may occur long before infections are diagnosed, and in the community, he said. If you wait until the infections occur, you may be far too late to prevent others from infection with the same strains. […] Talbot and colleagues add to the mounting evidence that whole-genome sequencing surveillance is a critical tool for infection prevention in finding outbreaks and transmission that otherwise goes undetected with current infection prevention practices.
#95
https://www.healio.com/news/infectious-disease/20220527/genomic-surveillance-uncovers-clusters-of-mrsa-causing-bloodstream-infections
In summary, transmission events leading to invasive, antibiotic-resistant infections may occur long before infections are diagnosed, and in the community, he said. If you wait until the infections occur, you may be far too late to prevent others from infection with the same strains. […] Talbot and colleagues add to the mounting evidence that whole-genome sequencing surveillance is a critical tool for infection prevention in finding outbreaks and transmission that otherwise goes undetected with current infection prevention practices.
#96
https://www.healio.com/news/infectious-disease/20220527/genomic-surveillance-uncovers-clusters-of-mrsa-causing-bloodstream-infections
In summary, transmission events leading to invasive, antibiotic-resistant infections may occur long before infections are diagnosed, and in the community, he said. If you wait until the infections occur, you may be far too late to prevent others from infection with the same strains. […] Talbot and colleagues add to the mounting evidence that whole-genome sequencing surveillance is a critical tool for infection prevention in finding outbreaks and transmission that otherwise goes undetected with current infection prevention practices.
#97 SciELO Brazil – Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America
https://www.scielo.br/j/bjid/a/XZKMpn6rnHnpSgNwfDPZdFg/
Despite these efforts, resources for monitoring the changing epidemiology of MRSA remain limited, and the true nature and extent of MRSA infections in the region are not well understood. […] Wider-reaching and coordinated programs to provide regular surveillance reports are needed to support clinicians and infection control committees faced with the challenges of treating and preventing infections due to MRSA. […] Surveillance of MRSA infections is important in both healthcare and community settings due to the continuously changing epidemiologic profile of MRSA. […] The overall goal of surveillance in public health is to provide information to decrease morbidity and mortality, and to improve health. […] A surveillance system for MRSA could range from a simple system, in which data are collected from a single hospital, to a complex electronic system that receives and integrates data from multiple sources.
#98 MRSA compendium of epidemiology, transmission, pathophysiology, treatment, and prevention within one health framework
https://pmc.ncbi.nlm.nih.gov/articles/PMC9871788/
However, the existence of some virulence factors is independent of the genomic structure and are related to clonal type. […] Methicillin resistant strain of S. aureus (MRSA) is an emerging pathogen that can cause mild to serious infections in both animals and humans. […] Among humans, it mostly causes mild to life deadly infections such as skin and soft tissue infections which are staphylococcal scalded skin syndrome (SSSS), pustules, impetigo contagiosa, abscesses, and papules while deadly infections include TSS, pneumonia, or newborn TSS-like exanthematous disease in humans. […] Among the 100,000 cases of MRSA infections per year, 20% of the patients died. […] The emergence of LA-MRSA and its transmission to humans and reports of humans strains in animals further increases the pathogenicity of MRSA as now MRSA have diversity of host species which results in genomic modification and increases the antibiotic resistance. […] The development of novel ways to combat antibiotic resistance and production of vaccine very important in this era.
#99 Vital Signs: Epidemiology and Recent Trends in Methicillin-Resistant and in Methicillin-Susceptible Staphylococcus aureus Bloodstream Infections â United States | MMWR
https://www.cdc.gov/mmwr/volumes/68/wr/mm6809e1.htm
Invasive methicillin-resistant Staphylococcus aureus (MRSA) infections have been declining in health care settings; however, the rate of decline has recently slowed. […] Nearly 120,000 Staphylococcus aureus bloodstream infections and 20,000 associated deaths occurred in the United States in 2017. After years of progress, the rate of decline of MRSA bloodstream infections has slowed, whereas bloodstream infections caused by methicillin-susceptible S. aureus are increasing slightly in the community (3.9% annually, 2012-2017). […] Despite reductions in incidence of MRSA bloodstream infections since 2005, S. aureus infections account for significant morbidity and mortality in the United States. […] A critical assessment of recent trends and incidence of both MRSA and MSSA invasive disease in the United States is crucial to informing public health policy and formulating a framework of approaches to further prevent S. aureus infections.
#100 Canadian surveillance shows rise in MRSA, other healthcare-associated infections | CIDRAP
https://www.cidrap.umn.edu/healthcare-associated-infections/canadian-surveillance-shows-rise-mrsa-other-healthcare-associated
Data collected from 88 Canadian sentinel acute care hospitals from January 2017 through December 2021 show that rates of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs) rose by 35%, climbing from 0.84 to 1.13 infections per 10,000 patient-days. […] The study authors suggest the increase in CA-MRSA BSIs may be linked to a growing CA-MRSA reservoir in Canada, and that strategies that target the reduction and prevention of MRSA, such as screening and eradication of MRSA carriage, may reduce the overall burden of MRSA BSIs. […] „Consistent and standardized surveillance of epidemiologic and laboratory HAI data are essential to providing hospital practitioners with benchmark rates and informing infection prevention and control and antimicrobial stewardship policies to help reduce the burden of HAI and the impact of AMR in Canadian acute care hospitals,” the authors wrote. […] Consistent and standardized surveillance of epidemiologic and laboratory HAI data are essential.
#101 The global prevalence of methicillin-resistant Staphylococcus aureus colonization in residents of elderly care centers: a systematic review and meta-analysis | Antimicrobial Resistance & Infection Control | Full Text
https://aricjournal.biomedcentral.com/articles/10.1186/s13756-023-01210-6
Methicillin-resistant Staphylococcus aureus (MRSA) is a difficult to treat infection, particularly in residents of elderly care centers (ECCs). Despite the substantial burden of MRSA, an inadequate number of studies have analyzed MRSA prevalence in ECCs. […] We conducted a worldwide systematic review and meta-analysis on the prevalence and risk factors of MRSA in ECCs. […] The pooled global prevalence of MRSA was 14.69% (95% CI 12.39-17.15%; 16,793/164,717). […] Screening programs and preventive measures should target MRSA in ECCs due to the high global prevalence rates. […] Considering the significant toll of MRSA, monitoring the extent of colonization, and identifying the key risk factors of MRSA acquisition in ECCs is essential for controlling and reducing the burden of this disease in ECCs residents.
#102 Geographic surveillance of community associated MRSA infections in children using electronic health record data | BMC Infectious Diseases | Full Text
https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-3682-3
The importance of achieving these goals would allow public health officials and area primary care providers to combat the spread of CA-MRSA infections through targeted interventions aimed at those communities at highest risk for acquisition and transmission. […] Hospital-based electronic health data systems in conjunction with spatial analyses can provide an effective surveillance system, which could be used to develop strategies for preventing CA-MRSA transmission.