METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS IN WESTERN-AUSTRALIA, 1983-1992

A statewide screening programme has prevented imported strains of meth icillin-resistant Staphylococcus aureus (MRSA) from becoming establish ed in any hospital in Western Australia (WA). Recently, notifications of MRSA in WA have increased, prompting a review of surveillance data for the period 1983-1992. Our aims were to determine: (i) the distribu tion by age and sex of persons with MRSA; (ii) changes in notification rates over time and by location in WA; and (iii) temporal changes in antimicrobial resistance patterns. There were 631 notifications of MRS A for the 10 year period 1983-1992, ranging from a low of 36 in 1988 t o a high of 117 in 1992. When the distribution by age and sex was exam ined, three age group peaks were apparent: 0-9 years, 20-39 years and 60-79 years. There was a predominance of females in the 20-39 years ag e group, reflecting a greater proportion of hospital nursing staff car rying MRSA. In those aged 50 years or more, there was a marked predomi nance of males. The highest notification rates overall occurred in the remote Kimberley region of WA, however, rates increased significantly in all regions of the state in 1992. Based on antimicrobial resistanc e patterns, MRSA was classified into two groups: multiresistant import ed strains which often caused outbreaks in hospitals; and a less resis tant MRSA (WA MRSA). WA MRSA appears to have originated in the Kimberl ey region and then spread widely in the community to other regions of the state, and the proportion of WA MRSA has increased significantly s ince 1989.