Methicillin-resistant Staphylococcus aureus (MRSA) in the UIi

MRSA assumed headline status in the UK in the early 1990s. UK government reports on antimicrobial resistance and hospital infection stimulated further interest in the late 1990s and rates of MRSA bacteraemia by hospital have been collected and released to the public domain by mandate since April 2001. The Public Health Laboratory Services (PHLS) Communicable Disease Report (CDR), stating numbers of hospitals affected by 'EMRSA' strains and staphylococcal bacteraemiae, gave the best epidemiological view until recently. However, the emergence of EMRSA-15 and -16 led rapidly to the establishment of endemic transmission in many hospitals and a major rise in clinical MRSA sepsis, with surprisingly few comprehensive reports at the hospital level of this major epidemiological change. This article discusses these changes, their impact on the health care system, reasons for the prevalence of MRSA, recent developments in its surveillance and, finally, new challenges and opportunities afforded by this organism.