Methicillin-resistant Staphylococcus aureus (MRSA) emerged as one of the most important causes of hospital-acquired bloodstream infections (BSIs), especially the multidrug resistant clones. The aim of the present study was to compare prevalence and resistance patterns of MRSA bacteremia in the major tertiary-care academic and referral center in Serbia before and after implementing an active antimicrobial resistance (AMR) surveillance. Laboratory-based before-after study was conducted during a two-year period (January 2012 to December 2013) in Clinical Centre of Serbia. Isolation and identification of bacterial strains were done following standard microbiological procedures. During the AMR surveillance, nearly twice more bloodstream samples were collected compared to the year without surveillance (1,528 vs. 855). In total, 43 isolates of MRSA were identified. MRSA was significantly more prevalent during the AMR surveillance compared to the previous year [14 (66.7%) to 29 (76.3%); P = 0.046]. During the AMR surveillance, MRSA more frequently originated from medical departments compared to intensive care unit, surgical department, and internal medicine (P = 0.027) indicating increasing MRSA infections in patients with less severe clinical condition and no apparent risk factors. Higher prevalence of MRSA and its lower susceptibility to erythromycin were revealed by implementation of active AMR surveillance, which may reflect more thoughtful collection of bloodstream samples from patients with suspected BSI.

中文翻译：

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加入国际监测抗菌素耐药性计划前后，三级中心MRSA流行率和耐药性模式的差异。

耐甲氧西林金黄色葡萄球菌（MRSA）成为医院获得性血流感染（BSI）的最重要原因之一，尤其是耐多药的克隆。本研究的目的是比较在实施主动抗菌素耐药性（AMR）监测之前和之后，塞尔维亚主要三级医疗学术和转诊中心中MRSA菌血症的患病率和耐药模式。在两年期间（2012年1月至2013年12月）在塞尔维亚临床中心进行了基于实验室的前后研究。按照标准的微生物学程序进行细菌菌株的分离和鉴定。在AMR监测期间，与没有监测的年份相比，采集的血液样本几乎多了两倍（1,528与855）。总共，鉴定出43种MRSA分离株。与上一年相比，在AMR监测中MRSA的发生率显着更高[14（66.7％）至29（76.3％）；P ＝ 0.046]。在AMR监测过程中，与重症监护室，外科部门和内科药物相比，MRSA来自医疗部门的频率更高（P = 0.027），这表明临床状况较轻且无明显危险因素的患者中MRSA感染的增加。积极的AMR监测显示，MRSA的患病率较高，对红霉素的敏感性较低，这可能反映出从可疑BSI患者中收集的血流样本更为周到。在AMR监测过程中，与重症监护室，外科部门和内科药物相比，MRSA来自医疗部门的频率更高（P = 0.027），这表明临床状况较轻且无明显危险因素的患者中MRSA感染的增加。积极的AMR监测显示，MRSA的患病率较高，对红霉素的敏感性较低，这可能反映出从可疑BSI患者中收集的血流样本更为周到。在AMR监测期间，与重症监护室，外科部门和内科药物相比，MRSA来自医疗部门的频率更高（P = 0.027），这表明临床状况较轻且无明显危险因素的患者中MRSA感染的增加。积极的AMR监测显示，MRSA的患病率较高，对红霉素的敏感性较低，这可能反映出从可疑BSI患者中收集的血流样本更为周到。