title: Methicillin-resistant Staphylococcus aureus: a 5-year review of surveillance data in a tertiary care hospital in Saudi Arabia.
abstract: BACKGROUND
  Staphylococcus aureus is an important pathogen that leads to serious infections in the community and in hospitals. Evidence has shown that the prevalence of infection and colonization with drug-resistant S. aureus, such as methicillin-resistant S. aureus (MRSA) and glycopeptide intermediately susceptible S. aureus, is increasing. Authorities must be aware of the prevalence of MRSA infection and colonization in their country in order to implement and monitor infection control policies that help curtail further emergence of this pathogen.
  
  
  OBJECTIVE
  To examine the trend of hospital-acquired MRSA infection and colonization in a tertiary care institution in Saudi Arabia during a 5-year period in order to identify specific areas at high risk for MRSA transmission, and to review our MRSA decolonization procedure and outcomes.
  
  
  METHODS
  Surveillance data prospectively collected from January 1, 2000, through December 31, 2004, on hospital-acquired (HA) MRSA were analyzed, with an emphasis on the trend of HA-MRSA infection and colonization, areas of high transmission, risk factors, and effectiveness of the implemented decolonization policy.
  
  
  RESULTS
  During the study period, 442 cases of HA-MRSA infection and colonization were identified. Of these, 51.2% were infections, and 48.8% were colonizations. An increasing trend in the incidence rates of infection and colonization was noticed during the study period, and most cases were identified on the surgical ward (33.3%) and medical ward (32.1%). Of the 34 infected patients who underwent systematic decolonization, 35.3% were successfully decolonized, and of the 11 who underwent topical decolonization, 63.6% were successfully decolonized.
  
  
  CONCLUSIONS
  The increasing trend of HA-MRSA infections has been a noticeable global problem. We identified a gradual increase in the rates of MRSA colonization and infection in a tertiary care center Saudi Arabia and recognize the importance of abiding by strict infection control policies, including hand hygiene and proper isolation practices. Continued surveillance for MRSA and other emerging multidrug-resistant pathogens is also needed.
authors.affiliation: Department of Infection Prevention and Control, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
authors.forename: H H
authors.initials: HH
authors.lastname: Balkhy
authors.forename: Z A
authors.initials: ZA
authors.lastname: Memish
authors.forename: M A
authors.initials: MA
authors.lastname: Almuneef
authors.forename: G C
authors.initials: GC
authors.lastname: Cunningham
authors.forename: C
authors.initials: C
authors.lastname: Francis
authors.forename: K C
authors.initials: KC
authors.lastname: Fong
authors.forename: Z B
authors.initials: ZB
authors.lastname: Nazeer
authors.forename: E
authors.initials: E
authors.lastname: Tannous
mesh_terms: D000328:Adult; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D011446:Prospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D018571:Sentinel Surveillance; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects*