Methicillin-resistant Staphylococcus aureus (MRSA): burden of disease and control challenges in Europe

R Köck,A W Friedrich,G Peters,M J Struelens,B Cookson,M Mielke,J E Van Gemert-Pijnen,A Navarro Torné,S Harbarth,R L Skov,K Becker,J Kluytmans,W Witte,E Tacconelli

doi:10.2807/ese.15.41.19688-en

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) isa major cause of healthcare- and community-associated infections worldwide. Within the healthcare setting alone, MRSA infections are estimated to affect more than 150,000 patients annually in the European Union (EU), resulting in attributable extra in-hospital costs of EUR 380 million for EU healthcare systems. Pan-European surveillance data on bloodstream infections show marked variability among EU Member States in the proportion of S. aureus that are methicillin-resistant, ranging from less than 1% to more than 50%. In the past five years, the MRSA bacteraemia rates have decreased significantly in 10 EU countries with higher endemic rates of MRSA infections. In addition to healthcare-associated infections, new MRSA strains have recently emerged as community and livestock-associated human pathogens in most EU Member States. The prevention and control of MRSA have therefore been identified as public health priorities in the EU. In this review, we describe the current burden of MRSA infections in healthcare and community settings across Europe and outline the main threats caused by recent changes in the epidemiology of MRSA. Thereby, we aim at identifying unmet needs of surveillance, prevention and control of MRSA in Europe.

Highlights

Concern about the burden of healthcare-associated infections (HAIs) has a significant European dimension
According to the pan-European surveillance systems, European Antimicrobial Resistance Surveillance System (EARSS) and HELICS, the prevalence of HA-MRSA infection markedly varies between countries but has been decreasing in several over the past five years
CA-MRSA infections have emerged in most European countries but are still less frequent overall than HA-MRSA infections

Summary

Introduction

Concern about the burden of healthcare-associated infections (HAIs) has a significant European dimension. The European Centre for Disease Prevention and Control (ECDC) has calculated that HAIs involve 4.1 million patients annually in the European Union (EU) Member States and that such infections directly result in approximately 37,000 deaths [1]. This worrisome incidence of HAIs is rightly considered a major patient safety issue. Another cause for concern is the continuous emergence of various multidrug-resistant bacteria in many healthcare institutions, which narrows the spectrum of effective antibiotics to a clinically challenging extent. We outline threats due to recent changes in the epidemiology of MRSA and identify unmet needs regarding surveillance, prevention and control of MRSA in Europe

Methods

Summary

95 MSSA vs 59 MRSA

Conclusions

Findings

Objective