A. Voss et al., METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS IN EUROPE, European journal of clinical microbiology & infectious diseases, 13(1), 1994, pp. 50-55
In order to obtain pan-European data on methicillin-resistant Staphylo
coccus aureus (MRSA), 43 laboratories from ten European countries each
screened 200 consecutive Staphylococcus aureus isolates for methicill
in resistance. Only one isolate per patient was permitted. All partici
pants used a uniform oxacillin-supplemented screening plate. MRSA isol
ates were sent to Munich for reconfirmation and further susceptibility
testing. Phage typing of the MRSA strains was performed in Denmark. O
f the 7,333 Staphylococcus aureus strains screened, 936 (12.8 %) were
methicillin resistant. The proportion of MRSA in the various European
countries ranged from < 1 % in Scandinavia to > 30 % in Spain, France
and Italy. Rates of resistance to the non-glycopeptide antibiotics wer
e lowest for rifampin and highest for ciprofloxacin. Sixty percent of
the methicillin-resistant strains originated from patients in surgical
and medical departments, with wounds being the most common isolation
source. MRSA was found more frequently in intensive care patients. Onl
y 13 % of the strains were non-typable, and 76 % of the isolates belon
ged to phage group III. For each area phage typing detected one or a f
ew dominating (epidemic) types, but 46 % of the strains did not belong
to these types; the MRSA population is thus a mixture of epidemic and
non-epidemic strains. MRSA seems to be a growing problem, especially
in southern Europe, where incidence and rates of antibiotic resistance
are alarmingly high.