Editorials

Controlling methicillin resistant Staphylococcus aureus

BMJ 2003; 327 doi: http://dx.doi.org/10.1136/bmj.327.7425.1177 (Published 20 November 2003) Cite this as: BMJ 2003;327:1177
  1. Georgia Duckworth, head (georgia.duckworth@hpa.org.uk)
  1. Division of Healthcare Associated Infection and Antimicrobial Resistance, Communicable Disease Surveillance Centre, Health Protection Agency, London NW9 5EQ

    Time to return to more stringent methods of control in the United Kingdom?

    Methicillin resistant Staphylococcus aureus (MRSA) is a major cause of hospital acquired infection worldwide, posing a growing threat to public health. It belongs to a species of ubiquitous and versatile organisms that are continually adapting to new antimicrobial and environmental challenges, often through gene transfers even from distantly related organisms such as vertebrates. Why is MRSA important? Some strains are eminently transmissible, resulting in large numbers of infections in hospitals. Bacteraemia data for England and Wales show that MRSA as a proportion of total Staphylococcus aureus bacteraemias rose from under 2% in 1990 to 42% in 20001 2—one of the highest reported rates in Europe.

    Methicillin resistance was first reported in 1961 shortly after the introduction of methicillin (similar to flucloxacillin), the first penicillin resistant to destruction by staphylococcal β-lactamase. The discovery of methicillin was an important development as many hospital strains of S aureus had become penicillin resistant in the 1950s through the production of β-lactamase.w1 Some European countries experienced problems with MRSA in the 1960s, but this was followed by …

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