The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carriage in patients presenting to a hospital emergency department.

摘要

Sir, Methicillin-resistant Staphylococcus aureus (MRSA) has been endemic in Australian hospitals for more than 25 years, and in order to limit transmission the focus has been on screening in order to detect and isolate or cohort colonised patients. In most of Eastern Australia, screening has not been universal but has focussed on risk groups, e.g., those with previous MRSA, those transferred from tertiary referral hospitals and residents of nursing homes. More recently, however, we have noted the emergence of new community strains of MRSA in patients who have never attended or infrequently attended hospital or other health care facilities. Although we suspect that community strains of MRSA are increasing in the community, we are not entirely sure what their prevalence is and at what rate they are increasing in different areas of Australia. Furthermore, as these community strains of MRSA occur in patient groups that do not have classic risk factors for MRSA, many of these patients will be missed in hospital admission screening programmes. It is therefore quite likely that there are a significant number of unknown MRSA positive patients being admitted to our hospitals and potentially contributing to unrecognised MRSA transmission.