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Contact: Andrew Hyde
Public Library of Science

Clustering MRSA in Europe indicates diffusion through regional health-care networks

A new study finds that methicillin-resistant Staphylococcus aureus (MRSA) –responsible for several difficult-to-treat infections including blood poisoning and pneumonia and a particular problem in hospitals – occurs in distinct geographical clusters across Europe, indicating that MRSA is being diffused by patients moving between hospitals rather than spreading freely in the community. The study, published in this week's PLoS Medicine, used an interactive Web tool to map different strains of the Staphylococcus aureus (S. aureus) bacterium across the continent.

MRSA infections have become more prevalent in hospitals over the past ten years, and information about its geographical distribution could help us to understand how it spreads and how to control it. In 2006 Hajo Grundmann, of the University Medical Centre in Groningen in the Netherlands, and colleagues assembled a large group of collaborators in 450 European hospitals located in 26 different countries. These hospitals collected both MRSA and methicillin-sensitive S. aureus (MSSA) isolates from infected patients – MRSA emerges when MSSA clones acquire resistance to antibiotics. National laboratories identified specific strains of S. aureus by molecular typing and entered this information into a Web-based mapping application which is publicly available (http://www.spatialepidemiology.net/srl-maps).

The results show that strains of MRSA tend to cluster within regional borders and, in several instances, were associated with individual hospitals. This suggests that MRSA is mainly spread by patients who are repeatedly admitted to different hospitals. "Control efforts aimed at interrupting the spread within and between health care institutions may not only be feasible but ultimately successful", conclude the researchers.

Franklin Lowy of Columbia University – uninvolved in the research – discusses the study in a Perspective and suggests that it "illustrates the ability of spatial mapping techniques to help understand the spread of new or re-emerging pathogens at the local as well as the international level''


Funding: All contributions from the staphylococcal reference laboratories were funded by national sources. Data collection, management, and analysis were funded by the Dutch Ministry of Welfare and Sports and the Directorate General for Health, Consumer Protection of the European Commission under the Agreement Number -2003212 and the Wellcome Trust under grant number 030662. SeqNet.org was partially funded by the Interregio Program of the European Union IIIA fund 2-EUR-V-1-96. The funders had no role in the design of the project, decision to publish, or preparation of the manuscript.

Competing Interests: DH is one of the developers of the Ridom StaphType software and the SpaServer mentioned in the manuscript. The client software is distributed and sold by the company Ridom GmbH, which is partially owned by him. All other authors have declared that no competing interests exist.

Citation: Grundmann H, Aanensen DM, van den Wijngaard CC, Spratt BG, Harmsen D, et al. (2010) Geographic Distribution of Staphylococcus aureus Causing Invasive Infections in Europe: A Molecular-Epidemiological Analysis. PLoS Med 7(1): e1000215. doi:10.1371/journal.pmed.1000215.

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000215

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-07-01-grundmann.pdf

Hajo Grundmann
National Institute for Public Health and the Environment
Antonie van Leeuwenhoeklaan 19
Bilthoven, 3720 BA
+31 30 274 4239

Related PLoS Medicine Perspective:

Mapping the Distribution of Invasive Staphylococcus aureus across Europe

Funding: The author received no specific funding to write this article.

Competing Interests: The author has declared that no competing interests exist.

Citation: Lowy FD (2010) Mapping the Distribution of Invasive Staphylococcus aureus across Europe. PLoS Med 7(1): e1000205. doi:10.1371/journal.pmed.1000205

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000205

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-07-01-lowy.pdf

Franklin Lowy
Columbia University, College of Physicians and Surgeons
630 West 168th street
New York, New York 10706
United States of America

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