Robin Köck, University Hospital Münster, Münster, Germany Annette Jurke, North Rhine-Westphalian Institute of Health and Work, Münster, Germany Inka Daniels-haardt, North Rhine-Westphalian Institute of Health and Work, Münster, Germany Julia E. W. C. Van Gemert-pijnen, University of Twente, Twente, Netherlands Karsten Becker, University Hospital Münster, Münster, Germany Alexander W Friedrich, University Hospital Münster, Münster, Germany Track: Research Presentation Topic: Public (e-)health, population health technologies, surveillance Presentation Type: Poster presentation Submission Type: Single Presentation Building: MECC Room: Trajectum Last modified: 2010-07-08

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Background: MRSA are major causes of healthcare-related infections in humans. A subtype of MRSA associated with S. aureus protein A (spa) type t011 (MLST ST 398) is clearly distinguishable from classical healthcare-associated MRSA and frequently colonizes livestock and humans exposed to such animals.
In the Dutch-German border area, characterized by a high density of pig-farming, a network of hospitals aiming at MRSA prevention was founded in 2005 (EUREGIO MRSA-net and EurSafety Health-net). All participating hospitals agreed upon performing spa typing of every first MRSA isolate from every patient. Typing data are entered into a regional Geographic Information System (GIS) indicating spacial and temporal trends.

Objective: Here, we present trends in the numbers of MRSA recovered from screenings and clinical specimens as well as typing results with an emphasis on spa types indicative for livestock association. Thereby, we aim at measuring the impact of an animal reservoir on the pool of MRSA circulating in regional human healthcare facilities.

Methods: The regional GIS was searched for isolates recovered from screenings and various clinical specimens (including blood cultures) obtained between 2006 and 2010 in all German network hospitals. Formation of spa clonal complexes (spa-CC) was performed using the Based Upon Repeat Pattern (BURP) algorithm.

Results: 1578 MRSA isolates were identified in 2006, 2426 in 2007, 2458 in 2008, 3896 in 2009 and 1001 in 2010(first quarter). Overall, 53% of the isolates were from screenings, 2% from blood cultures and 45% from other clinical specimens. The predominating spa types among all specimens were t003 (31%), t032 (28%), t011 (7%), t034 (4%), t004 (3%), t014 and t008 (each 2%), t002 (1%). In addition, we identified 380 other spa types each accounting for <1% of the isolates. Among MRSA isolates recovered from screenings, the proportion of spa-CC011 (indicating livestock-association) on all MRSA increased from 14% in 2006 to 22% in 2010. Overall, this proportion was 2% in blood cultures and 7% in other clinical specimens.

Conclusions: MRSA from livestock reservoirs are frequently introduced into regional German hospitals and cause human infections. The GIS allows regional infection control staff for monitoring temporal trends in the spread of MRSA and enables to assess the impact of MRSA reservoirs outside hospitals on the MRSA burden in healthcare facilities.