[Epidemic increase in methicillin-resistant Staphylococcus aureus in Copenhagen].
BACKGROUND
We have found an epidemic increase in methicillin-resistant Staphylococcus aureus (MRSA) in Copenhagen. The increase has a complex background and involves hospitals, nursing homes and persons nursed in their own home.


METHODS
We found 33 MRSA patients in 2003 and 121 in 2004. All isolates have been spa-typed and epidemiologic information collected.


RESULTS
The number of MRSA cases has a doubling time of about six months. The epidemic has been caused by many different MRSA types and 31 staphylococcus protein A genotypes (spa types). MRSA has caused several hospital outbreaks and is endemic in 10 nursing homes. Five staff members from nursing homes have been infected with MRSA. MRSA commonly causes skin and soft tissue infections (76%), but serious infections such as septicaemia and pneumonia are also found.


CONCLUSIONS
Treatment of MRSA-infected patients is costly due to isolation regimes, increase in bed-days and treatment with special antibiotics. After treatment of the infection and in cases of MRSA carriage, MRSA is found on the skin and in the nose. Carriage of MRSA can be eradicated by washing with chlorhexidine and nasal administration of mupirocin. The necessary resources for handling the epidemic are not available. Without active intervention, this situation will have serious implications for the health care system.
Westh
Henrik
H
H:S Hvidovre Hospital, Klinisk Mikrobiologisk Afdeling, Hvidovre. henrik.westh@hh.hosp.dk
Boye
Kit
K
Bartels
Mette Damkjaer
MD
Kristoffersen
Kirsten
K
Bergen
Lisbeth
L
Havstreym
Jeannette
J
Bagersted
Jytte
J
Petersen
Ina Sleimann
IS
Lester
Anne
A
Lisby
Jan Gorm
JG
Friis-Møller
Alice
A
Knudsen
Jenny Dahl
JD
Slotsbjerg
Torsten Dalgaard
TD
Lundgren
Bettina
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D003718:Denmark / Q000453:epidemiology; D004196:Disease Outbreaks / Q000517:prevention & control; D006801:Humans; D017053:Infection Control; D016106:Methicillin Resistance; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics / Q000276:immunology