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Third of MRSA cases contracted in community settings

By Lilian Anekwe

As many as a third of patients diagnosed with MRSA in hospital contracted the infection in the community, a new analysis concludes.

The study reveals the stark reality of the rise in community-acquired MRSA infections.

Pulse has previously reported that the rates of hospital admission for community-onset staphylococcal septicaemia, pneumonia and impetigo have risen more than fivefold over a 15-year period.

Mandatory surveillance of all diagnoses of MRSA in English hospitals was introduced in April 2001, and from January of this year, the Department of Health announced that all patients entering NHS hospitals in England would be screened for MRSA and Clostridium difficile.

An analysis of all reported cases of MRSA from English NHS acute trusts, by researchers at the Health Protection Agency's Centre for Infections, found 34% were likely to have been contracted in the community.

Between October 2005 and March 2008, approximately 14,000 reports of MRSA bacteraemia were received from all English acute Trusts.

Approximately 66% of MRSA bacteraemia cases were diagnosed two or more days after admission, indicating that they were probably acquired during that admission.

Approximately 6% were identified on presentation and a further 28% within two days of admission. The remaining one third of cases, the researchers argued, could have been acquired in the community – particularly in nursing homes.

Dr David Bridger, a researcher at the HPA's department of healthcare-associated infections and antimicrobial resistance, concluded: ‘These cases will often have previously been admitted to healthcare facilities and may have acquired their MRSA infection during earlier healthcare exposure.

‘However, a proportion of these cases will have been admitted from nursing care homes with the onset of the MRSA infection occurring in that setting.'

MRSA: third of cases from community MRSA: third of cases from community

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