title: Methicillin-resistant Staphylococcus aureus in North-east Croatia.
abstract: OBJECTIVE
  The aim of this 5-year study was to determine the frequency and antibiotic susceptibility of methicillin-resistant Staphylococcus aureus (MRSA)-related infections at Osijek Clinical Hospital.
  
  
  METHODS
  A total of 1987 staphylococci-infected clinical isolates were collected and analysed at the Microbiology Department of the Public Health Institute of Osijek-Baranja County.
  
  
  RESULTS
  Between 2008 and 2012, the average rate of MRSA-related infections in staphylococci-infected patients was 27.4%. The proportion of MRSA-related infections on all Staphylococcus aureus (S. aureus) isolates from clinical specimens showed a decreasing trend, from 32.6% in 2008 to 25.5% in 2012. MRSA-related infections were mostly detected in wound swabs (50.6%) and aspirates (28.8%) of patients hospitalized in the surgical (49.8%) and intensive care units (27.9%). MRSA-related infection showed an increase compared to S. aureus-infections in samples of wounds and aspirates in 2011 and 2012 (57.9%/34.9% and 35.2%/16.3%, respectively). The majority of strains of MRSA-related infections were resistant to several antibiotics, including erythromycin and clindamycin, where susceptibility were less than 10%. All MRSA isolates were susceptible to vancomycin, teicoplanin and linezolid. Therefore, antibiotic therapies for MRSA infections include vancomycin, teicoplanin and linezolid, but microbiological diagnostics need to be performed in order to know when the use of glycopeptides and oxazolidinones is indicated.
  
  
  CONCLUSIONS
  Our results suggest that appropriate prevention measures, combined with the more rational use of antibiotics are crucial to reduce the spread of MRSA-related infection in healthcare settings. Further monitoring is necessary of the incidence and antibiotic susceptibility of MRSA-related infections in our community.
authors.affiliation: Institute of Public Health for the Osijek-Baranja County, Osijek, Croatia.
authors.forename: Tajana
authors.initials: T
authors.lastname: Pastuović
authors.affiliation: Institute of Public Health for the Osijek-Baranja County, Osijek, Croatia. magdalena0706@gmail.com.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Perić
authors.affiliation: Institute of Public Health for the Osijek-Baranja County, Osijek, Croatia.
authors.forename: Zinka
authors.initials: Z
authors.lastname: Bošnjak
authors.affiliation: Institute of Public Health for the Osijek-Baranja County, Osijek, Croatia.
authors.forename: Nataša
authors.initials: N
authors.lastname: Ružman
authors.affiliation: University Hospital Osijek, Osijek, Croatia.
authors.forename: Patricia Reisz
authors.initials: PR
authors.lastname: Majić
authors.affiliation: Faculty of Medicine, Osijek, Croatia.
authors.forename: Jasminka
authors.initials: J
authors.lastname: Talapko
authors.affiliation: Institute of Public Health for the Osijek-Baranja County, Osijek, Croatia.
authors.forename: Vlasta
authors.initials: V
authors.lastname: Atalić
authors.affiliation: Institute of Public Health for the Osijek-Baranja County, Osijek, Croatia.
authors.forename: Snježana
authors.initials: S
authors.lastname: Loci-Zvocak
authors.affiliation: Institute of Public Health for the Osijek-Baranja County, Osijek, Croatia.
authors.forename: Dubravka
authors.initials: D
authors.lastname: Vuković
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017523:Croatia / Q000453:epidemiology; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control*; D024881:Drug Resistance, Bacterial; D006801:Humans; D015994:Incidence; D000069349:Linezolid / Q000008:administration & dosage; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D011634:Public Health; D018571:Sentinel Surveillance; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D017334:Teicoplanin / Q000008:administration & dosage; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D017334:Teicoplanin; D014640:Vancomycin; D000069349:Linezolid