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Prevalence of methicillin-resistant Staphylococcus aureus in the southern and eastern Mediterranean – final results from the ARMed project

Abstract number: 1732_77

Borg M.A., Scicluna E.A., van de Sande-Bruinsma N., de Kraker M., Tiemersma E.W., Monen J., Grundmann H., Collaborators ARMed Project

Objective: The high prevalence of methicillin resistant Staphylococcus aureus (MRSA) within the northern Mediterranean countries of Europe has already been documented. However, the concomitant situation in centres within the southern and eastern countries of the region was previously unknown. The Antibiotic Resistance Surveillance and Control in the Mediterranean Region (ARMed) project [www.slh.gov.mt/armed] provided a first time opportunity for a longitudinal multi-year study of trends of antimicrobial resistance amongst this species within these countries.

Methods: The ARMed project used comparable protocols to those adopted and validated by the European Antimicrobial Resistance Surveillance System (EARSS) and collected susceptibility test results from invasive isolates of S. aureus routinely isolated from blood in 59 participating laboratories within Algeria, Cyprus, Egypt, Jordan, Lebanon, Malta, Morocco, Tunisia and Turkey, who also took part in a external quality assurance programme throughout the project. The laboratories followed their routine procedures and breakpoints, which in 86.8% of the participants were based on CLSI (formerly NCCLS) guidelines. MRSA incidences at country level for 2005 were calculated by combining resistance data from the ARMed database with information on total number of patient days on the basis of hospital codes.

Results: A total of 5,353 S. aureus isolates were reported to ARMed for the whole study period (2003–2005), with an average MRSA proportion of 38%. MRSA incidence ranged from 4.61 per 100,000 patient days in Morocco to 18.37 in Egypt. Laboratories in Egypt, Jordan, Cyprus and Malta reported prevalence in excess of 50% in at least two out of the three study years. Furthermore, over the study period, significant increases were observed in Egypt (33% to 63%) and Malta (43% to 55%) whilst decreases were reported in Jordan (66% to 32%) and Turkey (43% to 35%).

Conclusion: ARMed resistance data has improved the MRSA epidemiological picture within the whole Mediterranean area and confirmed that the region as a whole exhibits a high prevalence. Other data from the whole region collected by ARMed as well as by other projects appears to suggest that antimicrobial consumption together with sub-optimal infection control infrastructure and activities may be important drivers behind this high prevalence situation and merit further research in the future.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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