Decreasing incidence of MRSA following the release of new national guidelines in Denmark

  • Robert Skov, Statens Serum Institut, Denmark
  • Marit Sørum, Statens Serum Institut, Denmark
  • Anders Larsen, Statens Serum Institut, Denmark
  • Marc Stegger, Statens Serum Institut, Denmark
  • Sidsel Böcher, Statens Serum Institut, Denmark
  • Louise Finne, Statens Serum Institut

    • Objective: Denmark experienced a large increase in the number of MRSA cases in 2002-2005. The increase was observed in both hospitals, nursing homes and in the community. The increase prompted a revision of the infection control guidelines for MRSA. As a result a new national set of guidelines including guidelines for eradication treatment of MRSA carriage was launched November 2006. MRSA, both carriage and infections became notifiable at the same time. Here we report the 2007 MRSA data and compare this to previous years.
    Material and Methods: All isolates from new MRSA cases in Denmark has been collected and typed at the Staphylococcus laboratory, Statens Serum Institute since 1988. Starting in 1999 clinical and epidemiological information was collected from hospital discharge summaries and notes from generl practitioners. From November 2006 has has been collected trough notification forms. Infections were classified as import, hospital acquired (HA), community onset with health care association (HACO), community associated (CA) and unresolved.
    Results: A total of 659 new MRSA cases were reported in 2007. This is a reduction from 705 cases (6.5%) in 2006 and a 23% reduction compared to 2005 (856 cases). Clinical information was available for 592 cases, which showed that 338 were infections and 154 were colonisations at the time of detection. The following distribution was found (total/no of cases with infections at the time of diagnosis) CA-MRSA (301/167), HACO (122/77), Import (96/64), HA (59/25) and unresolved (14/6). Especially HA infections and Haco infections decreased 73 vs 25 and 122 vs 77 for 2006 and 2007 respectively. CA infections decreased from 193 to 167 cases, whereas the number of imported infections increased from 57 to 64 cases - itshould be noted that information is missing for 67 cases (some being carriage only). Skin and soft tissue infections dominated
    Conclusion: A decreasing number of new MRSA cases were observed in 2007 following the release of new national guidelines. The majority of cases were detected in the community. Many cases were imported.