1. ¹Department of Clinical Haematology, Nottingham University Hospitals, Nottingham, UK
2. ²Department of Microbiology and Infection Control, Nottingham University Hospitals, Nottingham, UK

Correspondence: Dr BE Shaw, Department of Haematology, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. E-mail: bshaw@doctors.org.uk

Received 21 August 2006; Revised 22 December 2006; Accepted 29 December 2006; Published online 26 March 2007.

Abstract

Meticillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen, with an increased incidence in the UK since 1993, causing serious morbidity and mortality in immunosuppressed patients. We analysed the frequency and outcome of MRSA infection in a single-centre transplant population over a 5-year period. The total number of patients infected was 41/776 (5%). The frequency in autologous, sibling and unrelated donor transplants was 3, 6 and 9%, respectively. Prior to 2004, the incidence was <4%/year; however, an outbreak in the day unit resulted in 22 patients becoming newly infected. Over 90% of infections were clinically relevant, half (49%) being bacteraemia. Three patterns were seen: known MRSA positive at any time before transplant (n=15), MRSA first detected during the neutropenia phase (n=5) and MRSA only post discharge (n=21). MRSA was implicated in a number of deaths, at all time points, in those infected. An intensive eradication policy resulted in new infections dropping to <2%. In conclusion, MRSA is likely to remain endemic in our unit, but robust early screening protocols and aggressive eradication strategies have effectively limited the spread of and morbidity due to this pathogen.