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Trends of meticillin-resistant Staphylococcus aureus prevalence in ambulatory care in the Berlin area, 2000–2006

Abstract number: P1735

Noll I., Zill E., Emrich D., Chahin M., An der Heiden M., Eckmanns T.

Objectives: Surveillance data prove an increase in meticillin-resistant Staphylococcus aureus (MRSA) prevalence in German hospitals since the 1990s. Little is known about the situation in ambulatory care settings in Germany. A dataset from a laboratory serving for physicians in the city and surroundings of Berlin covering the period from 2000 to 2006 was analysed.

Methods:Staphylococcus aureus identification and antimicrobial susceptibility testing (AST) were performed by VITEK 1 system (bioMerieux). The phenotypical detection of MRSA was confirmed by subsequent PCR for MecA gene. Trends stratified for disciplines (internal medicine, general medicine, surgery, paediatrics, gynaecology and ear, nose and throat) and materials were calculated.

Results: In 12,723 (10.1%) out of 125,822 clinical specimens a S. aureus was detected. For 11,993 (94.3%) isolates AST was carried out resulting in an average MRSA proportion of 13.2 percent. From 2000 to 2006 the overall percentage of MRSA in ambulatory care increased from three percent to 17 percent with a yearly increment of 2.4% (CI: 2.0–2.8). With regard to specimen type the sample was composed as follows: 37.0% of the isolates came from wound swabs, 26.3% from swabs of unknown sites, 26.2% from nose and throat swabs, 7.0% from urines, and 3.5% from sputum. MRSA proportions ranged from 11.1% in urines to 14.8% in nose and throat swabs. Results can be stratified by the specialty of the physician who sent the specimen: MRSA proportions differ significantly with highest proportions in internal medicine (28.1%), followed by GPs (16.1%) and surgery (9.8%) and low proportions in ENT (3.8%), paediatrics (1.6%), and gynaecology (0.9%). The amount of community acquired MRSA cannot be estimated. All disciplines except paediatrics and gynaecology showed an increase over the years. Internal medicine peaked with 36% in 2006.

Conclusions: Analysis of AST data from the Berlin area showed a continuous increase of MRSA proportions in ambulatory care settings within the period from 2000 to 2006 reaching and passing levels known from hospital settings. In the light of these results the ambulatory care sector should be included into a national antimicrobial resistance surveillance system; this will be started in Germany in 2008.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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