Methicillin-resistant Staphylococcus aureus (MRSA)
has been an infection control problem ever since it
was first discovered in 1961.1 Like its susceptible
counterpart it is a common cause of skin, soft tissue
and wound infection as well as deeper sepsis such as
osteomyelitis and endocarditis. Although MRSA is
thought to be no more virulent than methicillin-susceptible
S. aureus (MSSA), infections are more difficult
and expensive to treat. This is partly because, as
well as being resistant to all b-lactam antibiotics,
resistance rates for other antibiotics are also high.
Most concerning has been the detection of MRSA
with reduced susceptibility to the glycopeptides,
vancomycin and teicoplanin, which are widely
regarded as the definitive therapy.2,3 MRSA is now a
world-wide phenomenon and the incidence continues
to rise.4,5 In view of this and the consequent
implications for morbidity and cost, many hospitals
have attempted to control the spread of MRSA.
Before the most effective methods of control can be
developed, however, it is important fully to understand
the epidemiology of the organism. Without a
thorough knowledge of the factors which affect the
acquisition of MRSA and the transmissibility of
different strains, it will not be clear which measures
should be put in place to stop it. A prerequisite for a
successful epidemiological investigation is a reliable
indicator of the relationship between the organisms
isolated, in other words, a typing scheme.
At present there is no consensus regarding the
best method to use for typing MRSA. In order to be
effective it should be highly discriminatory, reproducible,
standardized, based on a stable feature,
widely available, inexpensive and have performed
satisfactorily in an epidemiological investigation.6
The aim of this review is to critically assess the
information available on techniques that have been
used for MRSA strain differentiation in order to
judge which merit further consideration.
Methicillin-resistant Staphylococcus aureus (MRSA)
has been an infection control problem ever since it
was first discovered in 1961.1 Like its susceptible
counterpart it is a common cause of skin, soft tissue
and wound infection as well as deeper sepsis such as
osteomyelitis and endocarditis. Although MRSA is
thought to be no more virulent than methicillin-susceptible
S. aureus (MSSA), infections are more difficult
and expensive to treat. This is partly because, as
well as being resistant to all b-lactam antibiotics,
resistance rates for other antibiotics are also high.
Most concerning has been the detection of MRSA
with reduced susceptibility to the glycopeptides,
vancomycin and teicoplanin, which are widely
regarded as the definitive therapy.2,3 MRSA is now a
world-wide phenomenon and the incidence continues
to rise.4,5 In view of this and the consequent
implications for morbidity and cost, many hospitals
have attempted to control the spread of MRSA.
Before the most effective methods of control can be
developed, however, it is important fully to understand
the epidemiology of the organism. Without a
thorough knowledge of the factors which affect the
acquisition of MRSA and the transmissibility of
different strains, it will not be clear which measures
should be put in place to stop it. A prerequisite for a
successful epidemiological investigation is a reliable
indicator of the relationship between the organisms
isolated, in other words, a typing scheme.
At present there is no consensus regarding the
best method to use for typing MRSA. In order to be
effective it should be highly discriminatory, reproducible,
standardized, based on a stable feature,
widely available, inexpensive and have performed
satisfactorily in an epidemiological investigation.6
The aim of this review is to critically assess the
information available on techniques that have been
used for MRSA strain differentiation in order to
judge which merit further consideration.
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