Hospital-Acquired Methicillin-ResistantStaphylococcus aureus: Epidemiology, Treatment and Control

Coleman Rotstein

doi:10.1155/2006/703782

Abstract

Antimicrobial-resistant organisms are an expanding problem, resulting in increased morbidity and mortality, prolonged hospital stay, and heightened health care costs for care and antimicrobial management. Methicillin-resistantStaphylococcus aureus(MRSA) has emerged as a major hospital-acquired, antimicrobial-resistant pathogen. MRSA not only colonizes hospitalized patients but has a propensity to produce more serious, life- threatening infection than methicillin-susceptible strains. Numerous risk factors, including antimicrobial use and proximity to a patient harbouring MRSA, have been linked to the acquisition of MRSA. Although vancomycin has been the mainstay of therapy for MRSA, failures have been reported due to reduced susceptibility to this agent. Other available therapeutic agents for MRSA include trimethoprim-sulfamethoxazole, tetracycline, fusidic acid, rifampin (in combination with other effective agents) and linezolid. Potential therapeutic agents that are currently under investigation include daptomycin, dalbavancin, tigecycline, ceftobiprole and iclaprim. Only enhanced infection control practices can halt the progressive transmission of MRSA in the hospital environment. However, such measures have not quite fulfilled their promise in clinical studies. Moreover, eradication of MRSA colonization is controversial and may promote greater resistance. A multidisciplinary approach to the prevention, containment and treatment of MRSA is necessary.

Highlights

Les organismes résistants aux antimicrobiens représentent un problème croissant responsable de morbidité et de mortalité, d’hospitalisations prolongées, de frais de santé plus élevés en matière de soins et de prise en charge antimicrobienne
In the United States, more than 190 million courses of antibiotics are prescribed in hospitals annually and 145 million courses are prescribed in the community setting [3]
EPIDEMIOLOGY OF Methicillin-resistant Staphylococcus aureus (MRSA) IN CANADA Based on information from the Canadian Nosocomial Infection Surveillance Program (CNISP), 83% of all MRSA isolates can be directly attributed to a specific origin, while the other 17% are of unknown origin [7,8]

Summary

Introduction

Les organismes résistants aux antimicrobiens représentent un problème croissant responsable de morbidité et de mortalité, d’hospitalisations prolongées, de frais de santé plus élevés en matière de soins et de prise en charge antimicrobienne. MRSA poses considerable problems for health care facilities by prolonging the length of stay of patients, increasing the economic burden through additional hospital costs for barrier precautions and surveillance to identify patients colonized with the organism, and producing negative effects on patient care by using contact isolation precautions [10]. Kim et al [11] delineated the economic significance of MRSA in Canada by determining that a mean number of 14 additional hospital days were attributable to MRSA infection, with costs of $14,360 per patient.

Results

Conclusion