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The financial and patient morbidity and mortality burdens of invasive methicillin-resistant Staphylococcus aureus (MRSA) infection in the U.S. and many other countries are high. To better understand the infection burden in the U.S., researchers used data from the CDC's Emerging Infections Program–Active Bacterial Core surveillance system to examine the incidence of invasive MRSA disease in selected counties of nine states for 2005 and 2011. Cases were included if MRSA was isolated from sterile body sites, and were classified as hospital onset, healthcare-associated community onset (HACO), or community associated.
Overall, an estimated 80,461 cases occurred nationwide in 2011, compared with 111,261 in 2005 — a 31% decrease. Adjusted estimated incidence rates for hospital-onset, HACO, and community-associated infections decreased by 54%, 28%, and 5%, respectively. Among patients with nondialysis HACO infections in 2011, 64% had been hospitalized within the preceding 3 months and 32% resided in long-term care facilities.
Dantes R et al. National burden of invasive methicillin-resistant Staphylococcus aureus infections, United States, 2011. JAMA Intern Med 2013 Sep 16; [e-pub ahead of print]. (http://dx.doi.org/10.1001/jamainternmed.2013.10423)
Lowy FD. Methicillin-resistant Staphylococcus aureus: Where is it coming from and where is it going? JAMA Intern Med 2013 Sep 16; [e-pub ahead of print]. (http://dx.doi.org/10.1001/jamainternmed.2013.8277)
Comment
The findings of this survey are heartening — between 2005 and 2011, the incidence of hospital-onset invasive methicillin-resistant Staphylococcus aureus infection decreased by 54%, and the incidence of healthcare-associated community-onset infection fell by 28%. Despite these decreases, however, the rates remain unacceptably high. Strategies must be developed to reduce them further, with increased efforts in the community setting.