MRSA Review Warns of Potentially Explosive Outbreak

Surveillance, rapid screening, hygiene key to containment

TUESDAY, Sept. 5 (HealthDay News) -- Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) strains that are sufficient to maintain endemic levels in the community "could potentially become explosive," according to a review in the Sept. 2 issue of The Lancet.

In their review, Hajo Grundmann, M.D., of the National Institute for Public Health and the Environment in Bilthoven, the Netherlands, and colleagues outline the origin and future impact of MRSA.

The authors state that S. aureus gains resistance to multiple antibiotics through two main mechanisms: mutations in an existing gene and horizontal transfer of a mobile genetic element. Methicillin-resistance remains the most clinically important resistant trait since a single mutation confers resistance to most commonly prescribed antimicrobials. Recent work suggests that clones are becoming fitter through genomic variation.

"The onus is therefore on health-care authorities to develop not only surveillance systems that are able to monitor the clonal dynamics of MRSA over wide geographical areas, but also to provide the resources for early recognition of MRSA carriers through rapid screening," the authors write. "Hospital staff have a responsibility to implement, maintain, and adhere to strict contact precautions, should hospitals remain places where citizens can aspire to positive health-care outcomes with confidence.

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