MRSA deaths on the rise

December 12, 2002

Infections due to MRSA seem to be an increasing cause of death in England and Wales, concludes a study in this week's BMJ.

Whether deaths from MRSA infection have increased in the UK has been unknown until now because the World Health Organisation's International Classification of Diseases used for routine mortality statistics does not include a specific code for MRSA.

Researchers manually examined all death registrations between 1993 and 1998, indicating staphylococcal infection on any part of the death certificate, to identify MRSA from text entered on each line of the death certificate.

The percentage of such certificates, which included MRSA as a factor contributing in some way to the death of the person, increased from 7.5% in 1993 to 25% in 1998.

In certificates which gave staphylococcal infection as the underlying cause of death, the proportion mentioning MRSA increased from 8% in 1993 to 44% in 1998.

MRSA in staphylococcal septicaemia increased from 3% to 28%, staphylococcal pneumonia from 13% to 44%, and unspecified bacterial infection, staphylococcus from 19% to 83%. MRSA accounted for all of an increase in deaths due to staphylococcal infection in this period.

Infections due to MRSA seem to be an increasing cause of death in England and Wales, and improved reporting is unlikely to explain the increase, say the authors. The greatest rise in MRSA occurred for deaths where invasive staphylococcal infection was given as the final underlying cause, so antimicrobial resistance probably influenced the success of medical management.

Further improvements in surveillance and control of healthcare associated infection and mortality should be a priority if MRSA related deaths are to be prevented, they conclude.
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BMJ

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