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Updated: May 31, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Transmission dynamics of methicillin-resistant Staphylococcus aureus in a medical intensive care unit in India
Solomon Christopher1, Rejina Mariam Verghis, Belavendra Antonisamy
1Department of Biostatistics, Christian Medical College, Vellore, India. solomon.christopher@gmail.com
Background:
Methicillin-resistant Staphylococcus aureus (MRSA) is a global pathogen and an important but seldom investigated cause of morbidity and mortality in lower and middle-income countries where it can place a major burden on limited resources. Quantifying nosocomial transmission in resource-poor settings is difficult because molecular typing methods are prohibitively expensive. Mechanistic statistical models can overcome this problem with minimal cost. We analyse the transmission dynamics of MRSA in a hospital in south India using one such approach and provide conservative estimates of the organism's economic burden.
Methods And Findings:
Fifty months of MRSA infection data were collected retrospectively from a Medical Intensive Care Unit (MICU) in a tertiary hospital in Vellore, south India. Data were analysed using a previously described structured hidden Markov model. Seventy-two patients developed MRSA infections and, of these, 49 (68%) died in the MICU. We estimated that 4.2% (95%CI 1.0, 19.0) of patients were MRSA-positive when admitted, that there were 0.39 MRSA infections per colonized patient month (0.06, 0.73), and that the ward-level reproduction number for MRSA was 0.42 (0.08, 2.04). Anti-MRSA antibiotic treatment costs alone averaged $124/patient, over three times the monthly income of more than 40% of the Indian population.
Conclusions:
Our analysis of routine data provides the first estimate of the nosocomial transmission potential of MRSA in India. The high levels of transmission estimated underline the need for cost-effective interventions to reduce MRSA transmission in hospital settings in low and middle income countries.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) transmission in Indian hospitals is significant, with high infection rates and costs impacting low-resource settings. Cost-effective interventions are crucial to curb its spread.
Area of Science:
- Infectious Diseases
- Epidemiology
- Health Economics
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant global health threat, particularly in low and middle-income countries.
- Limited resources in these settings exacerbate the burden of MRSA-related morbidity and mortality.
- Traditional molecular typing for quantifying nosocomial transmission is often too expensive for resource-poor environments.
Purpose of the Study:
- To analyze the transmission dynamics of MRSA in a South Indian hospital.
- To estimate the economic burden of MRSA infections in a resource-limited setting.
- To provide a cost-effective method for quantifying nosocomial transmission.
Main Methods:
- Retrospective analysis of 50 months of MRSA infection data from a Medical Intensive Care Unit (MICU) in Vellore, South India.
- Application of a structured hidden Markov model to analyze transmission dynamics.
- Estimation of MRSA prevalence, incidence, and ward-level reproduction number.
Main Results:
- Seventy-two patients developed MRSA infections, with a 68% mortality rate in the MICU.
- Estimated 4.2% of admitted patients were MRSA-positive.
- Ward-level reproduction number for MRSA was estimated at 0.42.
- Average anti-MRSA antibiotic treatment cost was $124 per patient, exceeding the monthly income for over 40% of the Indian population.
Conclusions:
- This study provides the first estimate of MRSA's nosocomial transmission potential in India.
- The findings highlight substantial MRSA transmission, underscoring the need for effective, low-cost interventions.
- Urgent implementation of cost-effective strategies is required to mitigate MRSA spread in hospitals within low and middle-income countries.
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