Talk for hpa to be sorted out!

the BSAC Working Party on Resistance Surveillance
O40, 19th ECCMID, Helsinki, 16 - 19 May 2009
[email protected]
www.bsacsurv.org

British Society for Antimicrobial Chemotherapy (
BSAC)
Bacteraemia Resistance Surveillance Programme 2006-2007
HPA Centre for Infections, Colindale
Sponsors
Collecting Laboratories

England - MRSA screening and decolonisation
“From April 2009, all elective admissions must be screened for MRSA in line with Department of Health guidance. This should be extended to cover emergency admissions as soon as possible and definitely no later than 2011.”
Operational Guidance 2, Department of Health, December 2008
“We expect all patients who test positive for MRSA on screening prior to admission to be effectively decolonised, as indicated in previous guidance.”
Operational Guidance 2, Department of Health, December 2008
ALL elective NHS patients in England except:
•
day case opthalmology, dental & endoscopy;
children & maternity/obstetrics (except high risk groups and elective caesarean).
from Operational Guidance 2, DoH, December 2008
Monthly reporting to Department of Health:•
number of admissions and attendances of elective patients who should be screened;
number of tests done on these patients.
from Operational Guidance 1, DoH, July 2008

BSAC Bacteraemia Resistance Surveillance Programme

Prevalence of
mecA and
mupA
BSAC Bacteraemia Resistance Surveillance Programme 2006-07
487 S. aureus - 10
mupA-positive, from
7/26 centres3/5 countries70% hospital >48 hours
384 CoNS - 77
mupA-positive, from
BSAC Bacteraemia Resistance Surveillance Programme 2006-07

Association of
mecA and
mupA
BSAC Bacteraemia Resistance Surveillance Programme 2006-07
mupA and phenotypic mupirocin resistance 1
BSAC Bacteraemia Resistance Surveillance Programme - 2007 only
mupA and phenotypic mupirocin resistance 2
BSAC Bacteraemia Resistance Surveillance Programme - 2007 only

One coagulase-negative isolate under investigation:
• Highly resistant: MIC >1024 mg/L;•
mupA negative by at least two tests with different primers;• Hospital inpatient >48 hours, line-associated.
• 1 mupirocin-susceptible• 3
mupA-positive when tested with different primers.
Conclusions
mupA, encoding high-level mupirocin resistance, is:• currently rare in
S. aureus from bacteraemia (2%);• widespread in coagulase-negative staphylococci (20%);• more common in
mecA-positive (methicillin-resistant)
mupA-encoded mupirocin resistance could:• spread from coagulase-negative staphylococci to
S.
• rapidly become more prevalent under increased selective
Source: http://www.bsacsurv.org/uploads/publications/publications/2009_ECCMID_bact_mupirocin.pdf
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