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