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MRSA in community killing one in five

By Lilian Anekwe

New research on the threat of community-acquired MRSA (CA-MRSA) in primary care shows that as many as one in five patients who contract MRSA in the community are dead within a year.

An analysis of UK primary care data has shown that patients diagnosed with MRSA infections in the community have a four-fold higher rate of all-cause mortality.

Figures from the UK General Practice Research Database of 1,439 patients diagnosed with MRSA between 2001 and 2004, revealed 22% died in the year after diagnosis, compared to just 5% of age-matched controls.

The authors also observed an average of 360 MRSA infections diagnosed adults in the community every year.

A study of GPRD data by the same group published in July last year also provided strong evidence that prescribing antibiotics substantially increases the risk of contracting community-acquired MRSA (CA-MRSA).

Their research, published in the journal Emerging Infectious Diseases, found common antibiotics such as quinolones and macrolides can increase the risk of CA-MRSA by as much as six times.

The results were more startling as the raised risk was found in patients selected for the study because they had had no previous diagnosis of MRSA and no hospitalisation in the past two years – and so represent patients with true community acquired infections.

The risk of CA-MRSA varied according to the class of drug prescribed. The risk was highest for the quinolones, which increased the risk by more than three times, and the macrolides, which raise the risk by two and a half times when prescribed.

Exposure to any antibiotic drug in the 30-365 days before diagnosis was associated with nearly a 3-fold risk of an MRSA diagnosis, regardless of drug class and number of prescriptions.

In November Pulse reported the results of a GP survey that revealed more than 60% of GPs felt inadequately trained to tackle the rise of resistant infections, and less than a third said enough was being done to tackle resistant infections in the community.

Dr Schneider-Lindner, a researcher in epidemiology at McGill University and an author of the paper published in BMC Medicine, said the increased mortality ‘cannot be completely explained by underlying co-morbid conditions'.

She suggested that instead, ‘The increased mortality observed for MRSA infections may be a result of a health state that predisposes to MRSA infections'.

MRSA: community acquired illness killing one in five patients MRSA: community acquired illness killing one in five patients

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