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Updated: May 5, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 10, 2011
Health care-associated invasive MRSA infections, 2005-2008
Alexander J Kallen1, Yi Mu, Sandra Bulens
1Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. AKallen@cdc.gov
Context:
Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen of public health importance; MRSA prevention programs that may affect MRSA transmission and infection are increasingly common in health care settings. Whether there have been changes in MRSA infection incidence as these programs become established is unknown; however, recent data have shown that rates of MRSA bloodstream infections (BSIs) in intensive care units are decreasing.
Objective:
To describe changes in rates of invasive health care-associated MRSA infections from 2005 through 2008 among residents of 9 US metropolitan areas.
Design, Setting, And Participants:
Active, population-based surveillance for invasive MRSA in 9 metropolitan areas covering a population of approximately 15 million persons. All reports of laboratory-identified episodes of invasive (from a normally sterile body site) MRSA infections from 2005 through 2008 were evaluated and classified based on the setting of the positive culture and the presence or absence of health care exposures. Health care-associated infections (ie, hospital-onset and health care-associated community-onset), which made up 82% of the total infections, were included in this analysis.
Main Outcome Measures:
Change in incidence of invasive health care-associated MRSA infections and health care-associated MRSA BSIs using population of the catchment area as the denominator.
Results:
From 2005 through 2008, there were 21,503 episodes of invasive MRSA infection; 17,508 were health care associated. Of these, 15,458 were MRSA BSIs. The incidence rate of hospital-onset invasive MRSA infections was 1.02 per 10,000 population in 2005 and decreased 9.4% per year (95% confidence interval [CI], 14.7% to 3.8%; P = .005), and the incidence of health care-associated community-onset infections was 2.20 per 10,000 population in 2005 and decreased 5.7% per year (95% CI, 9.7% to 1.6%; P = .01). The decrease was most prominent for the subset of infections with BSIs (hospital-onset: -11.2%; 95% CI -15.9% to -6.3%; health care-associated community-onset: -6.6%; 95% CI -9.5% to -3.7%).
Conclusion:
Over the 4-year period from 2005 through 2008 in 9 diverse metropolitan areas, rates of invasive health care-associated MRSA infections decreased among patients with health care-associated infections that began in the community and also decreased among those with hospital-onset invasive disease.
Insights
Invasive health care-associated MRSA infections decreased significantly from 2005 to 2008. This includes both hospital-onset and community-onset infections, indicating progress in public health prevention programs.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) is a significant public health concern.
- MRSA prevention programs are increasingly implemented in healthcare settings.
- Recent trends suggest a decline in MRSA bloodstream infections (BSIs) within intensive care units.
Purpose of the Study:
- To analyze trends in invasive health care-associated MRSA infections.
- To examine changes in infection rates from 2005 to 2008.
- To cover 9 diverse US metropolitan areas.
Main Methods:
- Population-based surveillance of invasive MRSA infections.
- Inclusion of data from approximately 15 million individuals.
- Classification of infections by onset (hospital-onset vs. community-onset) and healthcare association.
Main Results:
- A total of 21,503 invasive MRSA episodes were recorded, with 17,508 classified as health care-associated.
- Incidence of hospital-onset invasive MRSA infections decreased by 9.4% annually.
- Incidence of health care-associated community-onset infections declined by 5.7% annually, with BSIs showing the most significant decrease.
Conclusions:
- Invasive health care-associated MRSA infections showed a downward trend from 2005 to 2008.
- Both hospital-onset and health care-associated community-onset MRSA infections decreased over the study period.
- These findings suggest the effectiveness of public health interventions in reducing MRSA burden.
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