Surveillance of hospital-acquired methicillin-resistant Staphylococcus aureus in South Australia.

In September 2001, the South Australian state-wide methicillin-resistant Staphylococcus aureus (MRSA) surveillance system was expanded to include three surveillance indicators namely: estimated MRSA burden, MRSA morbidity and estimated MRSA acquisition. The last two indicator rates have been stratified into intensive care unit (ICU) versus non-ICU. Between September 2001 and March 2002, state-wide MRSA burden rates (prevalence) ranged from 27.5 to 39.8 per 10,000 occupied bed days (OBDs). Acquisition rates ranged from 28.2 to 69.0 per 10,000 OBDs (ICU) and 6.3 to 10.1 per 10,000 OBDs (non-ICU). Morbidity rates ranged from 12.9 to 43.1 per 10,000 OBDs (ICU) and 3.0 to 5.0 per 10,000 OBDs (non-ICU). In association with the changes to surveillance indicators, a new monthly surveillance report was developed. Assuring confidentiality to individual contributing hospitals has been a major consideration in the development of the data collection system. Individual contributors have access only to their own indicator rates and pooled state-wide indicator rates. Contributing institutions are urged to use great caution if wishing to compare their own rates with state-wide rates. In particular, contributors are asked to take inter-institutional differences in MRSA burden and casemix complexity into account when making such comparisons.