Relationship between consumption of MRSA-active antibiotics and burden of MRSA in acute care hospitals in Catalonia, Spain
Authors: Grau Santiago , Fondevilla Esther , Freixas Núria , Mojal Sergi , Sopena Nieves , Bella Feliu , Gudiol Francesc ,   on behalf of the VINCat Group, Balet Antònia , Pérez Rafel , Pons Montserrat , García-Penche Rosa , Pérez Pepa , Barrera Maria Teresa , Casas Susana , Mestre Gabriel , Berbel Cristina , Enrique-Tarancon Gemma , Caro Silvia , Gayola Glòria , Palau Eva , Carrascossa Montserrat , Valls Camil·la , Martínez Maria Jesús , Fuster Mireia , Espejo Elena , Ibañez Ludivina , Sagalés Maria , Vázquez Rosa , Calonge Mònica , Tricas Josep Maria , Salse Lídia , Gimeno Elsa , Serrais Juan , Brugués Montse , López-Suñé Ester , Marco Francesc , Panisello Manel , Terré Susana , García Ángeles , Arranz Teresa , Cuscó Maria , Grañó Marisa , Pàez Francesc , de la Fuente José Carlos , Terré Susana , Ferrer Roser , Ayestaran Ana , Sierra Montserrat , Munell Leonor , Grabulosa Lourdes , Gol Virginia , Gassiot Paula , de Gamarra Edurne Fernández , Lopez-Contreras Joaquín , Smithson Àlex , Campins Lluís , Barrufet Mª Pilar , Bosacoma Núria , Oteiza Amaia Concepción , Flotats Elisenda , Morón Anisi , Fernández Inmaculada , Curiel Olga , Agustí Carme , Fraile Maria José , Clarós Mercè , Carrasco Natàlia , Lérida Ana , Espona Mercè , Gómez Julià , Vicente Esther , Marcos Pilar , Malo Roger , Alonso-Tarrés Carles , Capellà Anna , Díaz Vicens F. , Pascual Begoña , Grau Jordi , Garriga Maria Rosa , Riera Montserrat , Montserrat Magda , Camps Raimon , Benages Núria , Blancas David , Isern Marta , Curriu Margarida , Alemany Pilar , Bisbe Josep , Pujol Francesca , Gasós Mª Asunción , Juan Núria San , Coloma Ana Guadalupe , Martínez Isabel , Capdevila Pilar , Montardit Irene , Canadell Laura , García Graciano , Cano Santiago Manuel , Jover-Sáenz Alfredo , Palomar Mercedes , Padullés Ariadna , Hornero Ana , Motje Montse , Campany David , Larrosa Nieves , Borràs Ramon , Quesada Maria Dolores , Matas Lurdes , Salvador Pilar , Castro Antoni , Julián M. Esther , Pérez Mar Olga , Vidal Maria Àngels , Villó Josep Manel , Pujol Miquel , Limon Enric 
Published: November 2014

Abstract

Objectives
To analyse the possible relationship between consumption of old and new MRSA-active antibiotics and burden of MRSA in acute care hospitals in Catalonia during the period 2007–12.

Methods
Fifty-four hospitals participating in the VINCat Programme were included. Proportion of MRSA (resistant isolates of Staphylococcus aureus per 100 isolates of S. aureus tested), incidence of new cases of infection [new cases of MRSA per 1000 occupied bed-days (OBD)] and incidence of cases of bacteraemia (MRSA bacteraemia cases per 1000 OBD) were determined to estimate the annual MRSA burden. Antibiotic consumption was calculated in DDD/100 OBD. Cost was expressed in euros/100 OBD.

Results
MRSA rates remained stable over the study period, with the proportion of MRSA ranging from 20% to 22.82% in 2007 and 2012, respectively (P = 0.864). Consumption of old MRSA-active antibiotics (vancomycin and teicoplanin) did not change significantly, with values from 1.51 to 2.07 DDD/100 OBD (P = 0.693). Consumption of new MRSA-active antibiotics (linezolid and daptomycin) increased significantly, with values rising from 0.24 to 1.49 DDD/100 OBD (P &lt; 0.001). Cost increased by almost 200%.

Conclusions
A widespread and steady increase in consumption of new MRSA-active antibiotics was observed among acute care hospitals in Catalonia, in spite of a stable MRSA burden. At the same time, consumption of old drugs remained stable. Such trends resulted in a significant increase in cost. Our findings suggest that factors other than the proportion of methicillin resistance among S. aureus may influence the use of old and new MRSA-active antibiotics in the clinical setting.