Golden staph more prevalent in community than hospital
Half of all golden staph infections in Australia are caught outside a hospital, suggesting infection control efforts need to move from the hospital to the community, according to a new study.
The prevalence of multiple drug-resistant golden staph has declined, but most infections are now acquired in the community rather than in hospitals, requiring a change in the focus of infection control and antibiotic stewardship strategies, according to research published in the Medical Journal of Australia.
The authors looked at data from almost 40,000 people, finding that over 50% of people carrying antibiotic-resistant golden staph had not been admitted to hospital in the past year. They found that people who caught the bug in their communities were more likely to be aged below 40, Indigenous or living in an aged-care facility.
Methicillin-resistant Staphylococcus aureus (MRSA) is carried by between 0.7% and 2.2% of the Australian population, but was responsible for about 20% of S. aureus bacteraemia events in 2015, wrote the authors, led by Associate Professor John Ferguson, microbiologist and infectious diseases specialist at John Hunter Hospital in Newcastle.
“Our findings reflect progress in reducing (hospital onset) MRSA (HO-MRSA) rates, with MRSA isolation rates declining in the two largest hospitals,” the authors wrote. “Reduced HO MRSA rates have been documented elsewhere in Australia and attributed, in part, to the national hand hygiene initiative.
“Our results suggest that, to reduce the prevalence of non-multi-resistant phenotypes, the focus of control measures should move from the health care setting to the community.
“To meet the challenges of community-acquired MRSA, expanding infection control and antimicrobial stewardship measures beyond the hospital system is needed. National surveillance of MRSA is increasingly urgent, enabling reliable data from both public and private pathology providers to be collected and targeted and generalised control strategies to be identified and evaluated,” they concluded.
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