From: Reuters
Published April 3, 2008 08:03 PM

Resistant microbe entering hospitals

By Scott Baltic

NEW YORK (Reuters Health) - Most cases of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals originate in the hospitals themselves, but new research indicates that an increasing number of cases are now being brought into hospitals from the community.

The good news is that the community-associated strains appear to present no more danger to patients than the traditional, hospital-associated strains, according to the report in Clinical Infectious Diseases.

As the name implies, MRSA is a bacterium that is resistant to the antibiotic methicillin. However, it is also usually resistant to several other drugs, including penicillin and amoxicillin, which can make it difficult to treat. To prevent the spread of the microbe, which can cause a number of serious infections, affected patients are kept isolated from other patients.

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Dr. Kyle Popovich, at Stroger Hospital of Cook County, Chicago, and colleagues used a susceptibility algorithm to determine the origin of MRSA in 208 cases in which the infection began within 3 days of hospital admission.

During the study, which ran from 2000 to 2006, the proportion of cases due to community-acquired MRSA infection doubled from 24 to 49 percent. The length of hospital stay, likelihood of hospital readmission, and risk of death were comparable for patients infected with community- or hospital-associated strains.

"While our study showed similarities between community- and hospital-associated strains," Popovich told Reuters Health, "studies have shown virulent community MRSA strains exist, leading to (flesh-eating) skin infections, pneumonia and (blood infection)."

"Since community MRSA strains are entering the hospital, additional research into appropriate infection control strategies to reduce transmission and infection is needed."

In an accompanying editorial, Dr. John M. Boyce of Yale University School of Medicine gives a variety of recommendations for improving infection-control measures in hospitals, among them making personnel "aware that patients infected with MRSA are usually (harboring the microbe) at multiple body sites and that they often contaminate items in their immediate vicinity."

SOURCE: Clinical Infectious Diseases, March 15, 2008.

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