Large city hospitals breed and spread MRSA

Hospitals in large cities are the breeding grounds of the superbug MRSA which then spreads to other hospitals as patients are transferred researchers believe

The Edinburgh University team made the discovery by tracking MRSAs movements using its genetic code as a tag

In the study the infection started its journey in large city centre hospitals in London and Glasgow and then spread to smaller local hospitals

The work appears in the journal PNAS

The researchers say this knowledge could help in finding ways to prevent the spread of drugresistant infections

For example patients could be screened and treated for MRSA before transfer from one hospital to another Currently this is not a universal policy

However as part of the governments strategy to combat MRSA all patients going to hospital for a planned procedure are now offered a simple swab test to see whether they are carrying MRSA

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The high levels of patient traffic in large hospitals means they act as a hub for transmission between patients

Dr Ross Fitzgerald
Lead researcher
Stemming the spread
MRSA methicillinresistant staphylococcus aureus is a type of bacterial infection that is resistant to a number of widelyused antibiotics It first emerged more than 50 years ago

In recent years rates of MRSA have fallen because of increased awareness of the infection by both medical staff and the public However MRSA still places a considerable strain on healthcare services

It is spread by skintoskin contact with someone who has an MRSA infection or is a carrier The bacteria can also spread through contact with contaminated objects such as bedding and wound dressings Simple hygiene measures can prevent spread

The University of Edinburgh study looked at the genetic makeup of more than 80 variants of a major clone of MRSA found in hospitals that were collected from patients during a 53year period

This clone of MRSA called EMRSA16 only occurs in hospital settings The investigators estimated it had been around on UK wards for some 35 years

And they identified mutations and genetic elements that may have allowed this strain to spread within hospitals

Hub and spoke
In London it spread from large city hospitals to smaller surrounding hospitals in the south and southeast regions of England

Similarly Glasgow in west Scotland was a reservoir for transmission to regions in the north and east of Scotland

The investigators say more work is now needed on a larger number of samples to see if this is the case elsewhere in the UK

Lead researcher Dr Ross Fitzgerald of The Roslin Institute at the University of Edinburgh said These hospitals in large cities seem to be acting like a hub

The high levels of patient traffic in large hospitals means they act as a hub for transmission between patients who may then be transferred or treated in regional hospitals

This is the first time we have had genetic evidence for it And if we can identify the transmission routes we can take steps to prevent spread

Date : 15 May, 2012
Reference : http://www.bbc.co.uk/news/health-18062877

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