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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
12:18

Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)

Published on: February 9, 2011

Community-associated methicillin-resistant Staphylococcus aureus: risk factors for infection, and long-term follow-up

Y Longtin1, P Sudre, P François

  • 1University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|May 7, 2009
PubMed

Insights

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) risk factors in Europe remain unclear. A study found non-EU/Swiss nationality a risk factor, while decolonization strategies showed potential long-term efficacy.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Microbiology

Background:

  • Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) poses a persistent public health challenge in Europe.
  • Uncertainty exists regarding modifiable risk factors for CA-MRSA acquisition and the long-term effectiveness of decolonization interventions.

Purpose of the Study:

  • To identify independent risk factors associated with CA-MRSA infection in Geneva, Switzerland.
  • To evaluate the long-term efficacy of a systematic decolonization strategy for patients with Panton-Valentine leukocidin-producing CA-MRSA.

Main Methods:

  • A retrospective case-control study compared 26 CA-MRSA infected patients with 60 controls.
  • A prospective cohort study followed 79 patients undergoing decolonization for CA-MRSA isolates.
  • Statistical analysis included adjusted odds ratios (OR) and confidence intervals (CI).

Main Results:

  • Non-European Union/Swiss nationality (adjusted OR 6.09) and absence of healthcare contact (adjusted OR 0.11) were independent predictors of CA-MRSA infection.
  • Of 45 patients followed for a median of 22 months, 86.7% achieved sustained MRSA clearance after decolonization.
  • No significant difference in decolonization rates was observed between infected patients and asymptomatic carriers (92.6% vs. 77.8%).

Conclusions:

  • This study identified limited readily modifiable risk factors for CA-MRSA infection in the studied population.
  • Systematic decolonization strategies appear potentially useful, even in settings with sporadic CA-MRSA infections.
  • Further research is warranted to explore the role of migration in the emergence of CA-MRSA in Europe.

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