Improving surveillance of MRSA bacteraemia

Editor—Wyllie et al conclude that admission cultures accounted for 24% of total hospital methicillin resistant Staphylococcus aureus (MRSA) bacteraemia episodes over seven years to March 2004. Data collected from five district general hospitals and one university hospital in Cheshire and Merseyside and one district general hospital in greater Manchester support this view. This group of hospitals has collected enhanced MRSA bacteraemia surveillance data using published case definitions from the Department of Health since April 2004. Anonymised data are collected on paper forms and analysed using the FORMIC data capture system. In all, 534 cases of S aureus bacteraemia were identified between April 2004 and March 2005, 334 being methicillin sensitive S aureus bacteraemia and 200 MRSA bacteraemia. Sixty six of the MRSA bacteraemia cases occurred within 48 hours of arrival in hospital, 16 being related to a previous hospital admission, 25 in patients known to have been colonised with MRSA, and 13 in patients admitted from nursing or residential homes. Thirty five cases were admitted as medical specialties, 25 of them in patients over 65. Our results support the suggestion by Wyllie et al that anti-MRSA treatment should be considered for patients with possible staphylococcal sepsis who have previously been admitted or known to be colonised with MRSA. In a predominantly district general hospital setting, anti-MRSA treatment should also be considered for possible staphylococcal sepsis in elderly medical admissions and admissions from nursing homes. Judith A Bowley consultant microbiologist Southport and Ormskirk NHS Trust, Southport, Merseyside PR8 6PN [email protected] The eight other authors of this letter are Martin Kiernan, Karen Allen, Rizwan Khan, Maire O’Donoghue, Moira Taylor, Rachel Sen, Alan Wills, and Catherine Quigley.