According to a recent study published by the European Antimicrobial Resistance Surveillance System (EARSS), 65 per cent of MRSA cases in hospitals were diagnosed in the Intensive Care Unit (ICU) at St Luke’s Hospital during 2004 and 2005.
Fifty per cent of the MRSA cases were diagnosed in the Internal Medicine ward and 62 per cent were diagnosed in the surgical ward, the report said.
MRSA (methicillin resistant staphylococcus aureus) is used to describe the strains of this organism that are resistant to commonly used antibiotics.
The antibiotic methicillin was used many years ago to treat patients with staphylococcus aureus infections. It is now no longer used except as a way of identifying this particular type of antibiotic resistance.
EARSS is an international initiative funded by the director-general for Health and Consumer Protection (DG SANCO) of the European Commission and the Dutch Ministry of Health, Welfare and Sport.
The EARSS maintains a comprehensive surveillance and information system that links national networks by providing comparable and validated data on the prevalence and spread of major invasive bacteria with clinically and epidemiologically relevant antimicrobial resistance in Europe.
The highest percentage of hospital MRSA cases – 65 per cent – was diagnosed in people aged 65 and older.
In the 20 to 64 age group, 48 per cent were diagnosed with MRSA, closely followed by newborns to four years (47 per cent), and five to 19 years (44 per cent).
The study pointed out that vaccination, especially in young children, may represent an effective additional means of controlling antibiotic resistance in pneumococcal disease in Europe.
The increase of MRSA is consistent throughout Europe and includes countries with high, medium and low baseline MRSA endemicity. The study added that lower resistance prevails in the northwest of Europe, with increasing resistance towards the southeast of Europe.
It appears that the overall threat to European communities by the increasing loss of antimicrobial effectiveness continues unabated with the same speed as has been previously described by the EARSS.
The organism Staphylococcus aureus is found on the skin of many individuals and seems to cause no major problems. However, if it enters the body, for instance under the skin or into the lungs, it can cause serious infections such as boils or pneumonia.
Individuals who carry this organism are usually completely healthy, have no problems whatever and are considered simply as carriers of the organism.
If the organism is on the skin, then it can be passed around by physical contact. If it is in the nose or is associated with the lungs rather than the skin, it can be passed around by droplet spread from the mouth and nose.
MRSA strains are more frequently isolated from Intensive Care Unit (ICU) patients than non-ICU patients, the study said, and this is supported by the EARSS database. In the majority of countries, the proportion of MRSA was higher among ICU patients, except for most low-endemic countries.
In some countries, such as Poland, Bulgaria, Croatia, Greece, the UK, Cyprus and Romania, the proportion of MRSA found among ICU patients was over 60 per cent.
The study pointed out that these figures remain “concerning as it seems that ICU infection control procedures should be improved.”
However, Finland reported a relatively low number of MRSA cases, but had a disproportionately high MRSA rate among ICU patients.
The study found out that MRSA proportions had significantly increased during the last two years and this “could be consistent with outbreaks limited to ICU facilities in this country.”
Malta, along with France, Israel, Ireland and Portugal, also reported very similar MRSA proportions for ICU patients and patients from the other departments.
Within the last seven years, no fewer than 12 countries reported a significant increase in the proportion of MRSA.
However, the study said: “This is not part of an irreversible trend as two European countries – Slovenia and France – succeeded in constantly reducing the proportion of MRSA among staphylococcus aureus blood stream infections over the past five or six years.”
Doctors in Britain are frustrated that a new antibiotic, Tygacil, which has proved effective at fighting complicated skin or intra-abdominal infections caused by bacteria including MRSA, is not yet approved for use in England – but is available in Scottish hospitals.
Prof Mark Wilcox, a microbiologist at Leeds Teaching Hospital, said: “The findings in the EARSS report are worrying and clearly illustrate that antibiotic resistance is continuing to increase.” The British government insisted that infection rates were falling and pointed out that it had recently set aside an extra £50million fund for infection-control measures in hospitals.
A spokeswoman said: “We are not complacent. This is really important.”