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Updated: Jul 16, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Clinical impact of MRSA in a stem cell transplant unit: analysis before, during and after an MRSA outbreak
B E Shaw1, T Boswell, J L Byrne
1Department of Clinical Haematology, Nottingham University Hospitals, Nottingham, UK. bshaw@dostors.org.uk
Abstract:
Meticillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen, with an increased incidence in the UK since 1993, causing serious morbidity and mortality in immunosuppressed patients. We analysed the frequency and outcome of MRSA infection in a single-centre transplant population over a 5-year period. The total number of patients infected was 41/776 (5%). The frequency in autologous, sibling and unrelated donor transplants was 3, 6 and 9%, respectively. Prior to 2004, the incidence was <4%/year; however, an outbreak in the day unit resulted in 22 patients becoming newly infected. Over 90% of infections were clinically relevant, half (49%) being bacteraemia. Three patterns were seen: known MRSA positive at any time before transplant (n=15), MRSA first detected during the neutropenia phase (n=5) and MRSA only post discharge (n=21). MRSA was implicated in a number of deaths, at all time points, in those infected. An intensive eradication policy resulted in new infections dropping to <2%. In conclusion, MRSA is likely to remain endemic in our unit, but robust early screening protocols and aggressive eradication strategies have effectively limited the spread of and morbidity due to this pathogen.
Insights
Meticillin-resistant Staphylococcus aureus (MRSA) is a significant threat in transplant units. Implementing early screening and eradication strategies effectively reduced MRSA infections and associated morbidity.
Area of Science:
- Infectious Diseases
- Transplantation Medicine
- Clinical Microbiology
Background:
- Meticillin-resistant Staphylococcus aureus (MRSA) is a critical nosocomial pathogen, posing significant risks to immunocompromised patients, particularly in transplant populations.
- The incidence of MRSA infections has been increasing in the UK, leading to substantial morbidity and mortality.
Purpose of the Study:
- To analyze the frequency and outcomes of MRSA infections in a single-center transplant population over a five-year period.
- To evaluate the impact of an outbreak and subsequent control measures on MRSA incidence.
Main Methods:
- Retrospective analysis of MRSA infection data in 776 transplant patients over five years.
- Categorization of infections based on timing relative to transplant and detection phase.
- Implementation and assessment of an intensive MRSA eradication policy.
Main Results:
- Overall MRSA infection rate was 5% (41/776 patients), with higher frequencies in unrelated donor transplants (9%) compared to autologous (3%) and sibling (6%).
- An outbreak led to a surge in infections, with over 90% being clinically relevant, including 49% bacteraemia.
- An intensive eradication policy reduced new MRSA infections to below 2%.
Conclusions:
- MRSA is likely to remain endemic in transplant units, necessitating ongoing vigilance.
- Robust early screening protocols and aggressive eradication strategies are crucial for limiting MRSA spread and reducing patient morbidity.
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