Methicillin-resistant Staphylococcus aureus in Europe, 1999-2002
We explored the variation in proportions of methicillin-resistant Staphylococcus aureus (MRSA) between and within countries participating in the European Antimicrobial Resistance Surveillance System and temporal trends in its occurrence. This system collects routine antimicrobial susceptibility tests for S. aureus. We examined data collected from January 1999 through December 2002 (50,759 isolates from 495 hospitals in 26 countries). MRSA prevalence varied almost 100-fold, from <1% in northern Europe to >40% in southern and western Europe. MRSA proportions significantly increased in Belgium, Germany, Ireland, the Netherlands, and the United Kingdom, and decreased in Slovenia. Within countries, MRSA proportions varied between hospitals with highest variance in countries with a prevalence of 5% to 20%. The observed trends should stimulate initiatives to control MRSA at national, regional, and hospital levels. The large differences between hospitals indicate that efforts may be most effective at regional and hospital levels.
Staphylococcus aureus is an important cause of community- and hospital-acquired infections. Infections caused by methicillin- or oxacillin-resistant S. aureus (MRSA) are mainly nosocomial and are increasingly reported from many countries worldwide. As MRSA strains are frequently resistant to many different classes of antimicrobial drugs, second- and third-line antimicrobial resistance is a growing concern. Surveillance of MRSA provides relevant information on the extent of the MRSA epidemic, identifies priorities for infection control and the need for adjustments in antimicrobial drug policy, and guides intervention programs.
In Europe, several surveillance systems collect data on MRSA. Most collect data from specific types of hospitals, for certain periods, or information related to specific antimicrobial susceptibility patterns. The only ongoing initiative that continuously monitors antimicrobial resistance in most European countries is the European Antimicrobial Surveillance System (EARSS), funded by Directorate General for Health and Consumer Protection of the European Commission. This network connects national surveillance systems and provides comparable and validated results of routine antimicrobial susceptibility tests (AST) following standardized protocols from a representative set of laboratories per country. Timely and detailed feedback is given through a freely accessible and interactive Web site (http://www.earss.rivm.nl). EARSS was established in 1998 and currently connects >600 laboratories in 28 countries, which serve >100 million people. Preliminary EARSS results showed considerable differences in the proportions of MRSA across Europe.
We report results of antimicrobial susceptibility testing of S. aureus blood isolates from 1999 to 2002 in Europe; these results show variation in the prevalence of MRSA, including variation in its proportions at the hospital level. To assess recent changes in the epidemiology of MRSA within countries, we also present country-specific temporal trends in the occurrence of MRSA.
We explored the variation in proportions of methicillin-resistant Staphylococcus aureus (MRSA) between and within countries participating in the European Antimicrobial Resistance Surveillance System and temporal trends in its occurrence. This system collects routine antimicrobial susceptibility tests for S. aureus. We examined data collected from January 1999 through December 2002 (50,759 isolates from 495 hospitals in 26 countries). MRSA prevalence varied almost 100-fold, from <1% in northern Europe to >40% in southern and western Europe. MRSA proportions significantly increased in Belgium, Germany, Ireland, the Netherlands, and the United Kingdom, and decreased in Slovenia. Within countries, MRSA proportions varied between hospitals with highest variance in countries with a prevalence of 5% to 20%. The observed trends should stimulate initiatives to control MRSA at national, regional, and hospital levels. The large differences between hospitals indicate that efforts may be most effective at regional and hospital levels.
Staphylococcus aureus is an important cause of community- and hospital-acquired infections. Infections caused by methicillin- or oxacillin-resistant S. aureus (MRSA) are mainly nosocomial and are increasingly reported from many countries worldwide. As MRSA strains are frequently resistant to many different classes of antimicrobial drugs, second- and third-line antimicrobial resistance is a growing concern. Surveillance of MRSA provides relevant information on the extent of the MRSA epidemic, identifies priorities for infection control and the need for adjustments in antimicrobial drug policy, and guides intervention programs.
In Europe, several surveillance systems collect data on MRSA. Most collect data from specific types of hospitals, for certain periods, or information related to specific antimicrobial susceptibility patterns. The only ongoing initiative that continuously monitors antimicrobial resistance in most European countries is the European Antimicrobial Surveillance System (EARSS), funded by Directorate General for Health and Consumer Protection of the European Commission. This network connects national surveillance systems and provides comparable and validated results of routine antimicrobial susceptibility tests (AST) following standardized protocols from a representative set of laboratories per country. Timely and detailed feedback is given through a freely accessible and interactive Web site (http://www.earss.rivm.nl). EARSS was established in 1998 and currently connects >600 laboratories in 28 countries, which serve >100 million people. Preliminary EARSS results showed considerable differences in the proportions of MRSA across Europe.
We report results of antimicrobial susceptibility testing of S. aureus blood isolates from 1999 to 2002 in Europe; these results show variation in the prevalence of MRSA, including variation in its proportions at the hospital level. To assess recent changes in the epidemiology of MRSA within countries, we also present country-specific temporal trends in the occurrence of MRSA.
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