Superbug MRSA on rise in hospital outpatients, US

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Superbug MRSA poses a greater health threat than previously known and is making its way into hospitals, according to a study in the Emerging Infectious Diseases.

The study, which analyzed data from more than 300 microbiology labs serving hospitals all over the United States, found a seven-fold increase in the proportion of “community-associated” strains of methicillin-resistant Staphylococcus aureus, or MRSA, in outpatient hospital units between 1999 and 2006.

According to study authors, this increase threatens patient safety because doctors and patients often move back and forth between inpatient and outpatient units of a hospital.

“This emerging epidemic of community-associated MRSA strains appears to add to the already high MRSA burden in hospitals,” said Ramanan Laxminarayan, Principal Investigator for Extending the Cure, a project that examines policy solutions to the growing problem of antibiotic resistance based at the Washington, D.C. think-tank, Resources for the Future.

Over the length of the study, researchers found that the proportion of MRSA increased more than 90 percent among outpatients with staph and now accounts for more than 50 percent of all Staphylococcus aureus infections. The findings suggest that this was due almost entirely to an increase in community-associated strains, which jumped from 3.6 percent of all MRSA infections to 28.2 percent-a seven-fold jump from 1999 to 2006. Similar increases in inpatients suggest that these strains are spreading rapidly into hospitals as well.

“MRSA has generally been a significant problem only in hospitals,” said Eili Klein, the report’s lead author and researcher at Resources for the Future. “But the findings from this study suggest that there is a significant reservoir in the community as well.” This community reservoir leads to a dangerous spread of community-associated strains from outpatient units into hospitals, according to Klein.

To curtail this spread, hospitals will need to step up infection control procedures, including those practiced in outpatient units. This study and others suggest that the most effective way of containing MRSA and other superbugs is by employing surveillance and infection control on a regional basis.

Extending the Cure is supported by the Robert Wood Johnson Foundation’s Pioneer Portfolio, which funds innovative ideas that may lead to breakthroughs in the future of health and health care.

Source: Extending the Cure, USA


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