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Rate of Healthcare-Associated MRSA Infections Decreasing in the US CHICAGO -- August 11, 2010 -- An analysis of data from 2005 through 2008 of 9 metropolitan areas in the United States indicates that healthcare-associated invasive methicillin-resistant Staphylococcus aureus (MRSA) infections decreased among patients with infections that began in the community or in the hospital. The study is published in the August 11 issue of JAMA. Alexander J. Kallen, MD, Centers for Disease Control and Prevention, Atlanta, Georgia, and colleagues used a population-based surveillance system to evaluate the incidence of invasive health care-associated MRSA infections from 2005 through 2008 in 9 metropolitan areas covering a population of approximately 15 million persons. All reports of laboratory-identified episodes of invasive MRSA infections were evaluated and classified based on the setting of the positive culture and the presence or absence of healthcare exposures. Healthcare-associated infections (i.e., hospital-onset and health care-associated community-onset), which made up 82% of the total infections, were included in the analysis. Overall, the participating surveillances sites reported 21,503 cases of invasive MRSA infections for the years 2005 through 2008, with 17,508 cases either hospital-onset or health care-associated community-onset. Most healthcare-associated infections (15,458 [88%]) involved a positive blood culture and were classified as a bloodstream infection (BSI). "The modeled incidence, adjusted for age and race, of hospital-onset invasive MRSA infections significantly decreased 9.4% per year from 2005 through 2008; while there was a significant 5.7% decrease per year in the modeled incidence of health care-associated community-onset infections," the authors wrote. "This would equate to about a 28% decrease in all hospital-onset invasive MRSA infections and about a 17% decrease in all invasive healthcare-associated community-onset infections over the 4-year period." A subset analysis limited to BSIs demonstrated a larger decrease in the modeled yearly incidence rates of both hospital-onset (-11.2%) and healthcare-associated community-onset (-6.6%) BSIs, equating to about a 34% decrease in all hospital-onset MRSA BSIs and about a 20% decrease in all healthcare-associated community-onset BSIs over the 4-year period. The researchers added that although the reasons for the observed decrease in incidence of invasive healthcare-associated MRSA infections are not known, a number of factors might have contributed, including the dissemination of MRSA prevention practices in many US hospitals. "… this evaluation demonstrates that the incidence of hospital-onset and healthcare-associated community-onset invasive MRSA infections has decreased dramatically and significantly in this large geographically diverse population," the authors wrote. "Taken together with data from more than 600 intensive care units nationwide, these findings suggest that there is a real decrease in MRSA infection rates among patients in US hospitals. As highlighted in the recently finalised US Department of Health and Human Services Action Plan to Prevent Healthcare-Associated Infections, prevention of invasive MRSA infections is a national priority." "Although these data suggest progress has occurred in preventing healthcare-associated MRSA infections, more challenges remain," they continued. "Increasing adherence to existing recommendations and addressing MRSA transmission and prevention beyond inpatient settings are challenges that will require further effort and investigation if eliminating the goal of preventable health care-associated invasive MRSA infections is to be attained." SOURCE: JAMA E-mail this page to a friend or colleague! To print, use this version