One in four cases of MRSA bloodstream infection
in hospital occur in patients who have just arrived from the community,
Oxford researchers report in the British Medical Journal.
These patients
tend to be older and have been in hospital before.
The findings, published online at www.bmj.com, should help to refine
infection control policies in UK hospitals.
Researchers believe the newly admitted patients picked up MRSA from
a previous hospital stay, not from the community, because the pattern
of antibiotic sensitivity in the patients was typical of hospital-acquired,
not community, MRSA. The bacteria may have lain ‘dormant’ in
the patients since an earlier stay and then re-emerged, possibly when
the immune system was weakened.
In the past 10 years, MRSA infection has increased in the UK. The so-called ‘super-bug’ can
infect many sites, and one particularly serious form of infection is
that in which bloodstream infection occurs (bacteraemia). A national
surveillance scheme counts MRSA bacteraemia by hospital trust, but it
has not yet addressed whether cases of MRSA bacteraemia are arriving
in hospitals from the community.
Researchers at the University of Oxford analysed MRSA and methicillin
sensitive Staphylococcus aureus (MSSA) bacteraemia in patients on arrival
in two Oxfordshire hospitals over a seven year period (1997–2003).
At one hospital, patients admitted from the community accounted for
49 per cent of total MSSA cases and 25 per cent of total MRSA cases.
Most patients (at least 91 per cent) admitted with MRSA bacteraemia
had previously been in hospital, half had never had MRSA detected before,
and 70 per cent were admitted to emergency medical and surgical services.
Despite some study limitations, the authors conclude that, of the cases
of MRSA bacteraemia detected in hospital, a quarter occurs in patients
who have just arrived from the community, and that this proportion is
increasing. They call for additional research to be undertaken into the
best way to recognise these patients.
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any particular view or activity. Material in this news item
was first released by Oxford University (UK, England) on 9th September
2005. For further information, please
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