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MRSA: the problem reaches paediatrics
  1. J W Gray
  1. Correspondence to:
    Dr J W Gray
    Department of Microbiology, Birmingham Children’s Hospital, Steelhouse Lane, Birmingham B4 6NH, UK;

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Commentary on the paper by Khairulddin et al

The pattern of MRSA in UK hospitals nowadays is very different to that seen a decade or so ago. Then, MRSA was confined mainly to a relatively small number of hospitals in the southeast of England and some of the large provincial conurbations.1 However, new strains of epidemic MRSA, especially EMRSA-15 and EMRSA-16, have since emerged and spread to become established to some extent in virtually every hospital in the country.1 Between 1992 and 2002 the proportion of blood culture isolates of Staphylococcus aureus reported by microbiology laboratories to the Communicable Disease Surveillance Centre that were methicillin resistant increased from 3% to 43%.2 The pervasiveness of MRSA is underlined by the fact that MRSA now accounts for over 30% of S aureus bacteraemias in every health care region in England, Wales, and Northern Ireland.3

MRSA are frequently not only resistant to methicillin and other β-lactam antibiotics, but to other classes of antibiotics as well.1 The glycopeptide antibiotics teicoplanin and vancomycin are currently the mainstay of treatment of infections with MRSA.1 However, strains of MRSA have emerged that exhibit higher than usual minimum inhibitory concentration values for these antibiotics: glycopeptide-intermediate S aureus (GISA), or vancomycin resistant S aureus (VISA).4 Although not fully glycopeptide resistant, infections with these isolates often respond poorly to treatment with these agents. Fortunately only a small number of infections with these bacteria have been reported so …

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