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A descriptive survey of uncontrolled methicillin-resistant Staphylococcus aureus in a twin site general hospital
S P Barrett1, O N Gill, J A Mellor
1Department of Microbiology, Southend Hospital, Westcliffe-on-Sea, Essex.
Abstract:
Over a five year period beginning in 1981, during which control measures were applied intermittently, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) isolates increased steadily within a twin site general hospital. A retrospective chart review of 154 patients identified in 1984-1985 showed that the MRSA 'definitely' contributed to three deaths (2%) and 'probably' contributed to a further 15 (10%). The prolonged median duration of hospital admission (22 days) before first isolation of MRSA, together with the clustering of cases in time on certain wards, suggested that most, if not all, affected patients acquired the MRSA in hospital. As the virulence of MRSA in our outbreak appeared the same as that reported from teaching hospitals, MRSA control measures need to be comprehensively applied in general hospitals.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) incidence rose in a general hospital despite intermittent controls. This hospital-acquired infection contributed to patient deaths and prolonged hospital stays, highlighting the need for comprehensive MRSA control.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Antimicrobial Resistance
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings.
- The increasing incidence of MRSA necessitates understanding its transmission dynamics in general hospitals.
Purpose of the Study:
- To investigate the incidence and impact of MRSA in a general hospital over a five-year period.
- To determine the contribution of MRSA to patient mortality and morbidity.
- To identify factors associated with MRSA acquisition within the hospital.
Main Methods:
- Retrospective chart review of 154 patients identified with MRSA between 1984-1985.
- Analysis of MRSA isolate incidence trends from 1981 onwards.
- Assessment of MRSA's contribution to patient deaths and duration of hospital admission.
Main Results:
- A steady increase in MRSA isolates was observed despite intermittent control measures.
- MRSA was definitively linked to 2% of deaths and probably contributed to 10% of deaths.
- Prolonged hospital stays (median 22 days) before MRSA isolation and ward clustering suggested hospital acquisition.
Conclusions:
- MRSA acquisition occurred predominantly within the hospital environment.
- The virulence of MRSA in this general hospital outbreak was comparable to that in teaching hospitals.
- Comprehensive MRSA control measures are essential for general hospitals to mitigate spread and patient harm.