@article {5143,
	title = {Molecular epidemiology of MRSA in 13 ICUs from eight European countries.},
	journal = {J Antimicrob Chemother},
	volume = {71},
	year = {2016},
	month = {2016 Jan},
	pages = {45-52},
	abstract = {OBJECTIVES: The European epidemiology of MRSA is changing with the emergence of community-associated MRSA (CA-MRSA) and livestock-associated MRSA (LA-MRSA). In this study, we investigated the molecular epidemiology of MRSA during 2 years in 13 ICUs in France, Greece, Italy, Latvia, Luxemburg, Portugal, Slovenia and Spain.

METHODS: Surveillance cultures for MRSA from nose and wounds were obtained on admission and twice weekly from all patients admitted to an ICU for >=3 days. The first MRSA isolate per patient was genotyped in a central laboratory by MLST, spa typing, agr typing and SCCmec (sub)typing. Risk factors for patients with an unknown history of MRSA colonization were identified.

RESULTS: Overall, 14 390 ICU patients were screened, of whom 8519 stayed in an ICU for >=3 days. Overall MRSA admission prevalence was 3.9\% and ranged from 1.0\% to 7.0\% for individual ICUs. Overall MRSA acquisition rate was 2.5/1000 patient days at risk and ranged from 0.2 to 8/1000 patient days at risk per ICU. In total, 557 putative MRSA isolates were submitted to the central laboratory for typing, of which 511 (92\%) were confirmed as MRSA. Each country had a distinct epidemiology, with ST8-IVc (UK-EMRSA-2/-6, USA500) being most prevalent, especially in France and Spain, and detected in ICUs in five of eight countries. Seventeen (3\%) and three (<1\%) isolates were categorized as CA-MRSA and LA-MRSA, respectively. Risk factors for MRSA carriage on ICU admission were age >70 years and hospitalization within 1 year prior to ICU admission.

CONCLUSIONS: The molecular epidemiology of MRSA in 13 European ICUs in eight countries was homogeneous within, but heterogeneous between, countries. CA-MRSA and LA-MRSA genotypes and Panton-Valentine leucocidin-producing isolates were detected sporadically.},
	issn = {1460-2091},
	doi = {10.1093/jac/dkv298},
	author = {Hetem, D J and Derde, L P G and Empel, J and Mroczkowska, A and Orczykowska-Kotyna, M and Kozi{\'n}ska, A and Hryniewicz, W and Goossens, H and Bonten, M J M}
}
