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Original article

Vol. 146 No. 3738 (2016)

Staphylococcus aureus and methicillin resistance in Switzerland: regional differences and trends from 2004 to 2014

  • Flaminia Olearo
  • Werner C. Albrich
  • Nathalie Vernaz
  • Stephan Harbarth
  • Andreas Kronenberg
  • Swiss Centre for Antibiotic resistance (ANRESIS)
Cite this as:
Swiss Med Wkly. 2016;146:w14339


BACKGROUND: The global epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) is heterogeneous. The objective of this study was to evaluate MRSA epidemiology in Switzerland over an 11-year period.

METHODS: We conducted a retrospective study with time series analysis on S. aureus including MRSA and non-multidrug resistant MRSA (NmMRSA). We used NmMRSA as a marker for community-acquired MRSA. NmMRSA was defined as MRSA susceptible to at least three of the following agents: ciprofloxacin, clindamycin, tetracycline and trimethoprim-sulfamethoxazole.

RESULTS: A total of 14 648 MRSA and 115 917 methicillin-susceptible S. aureus (MSSA) isolates were included. Despite an overall decrease of the proportion of MRSA among S. aureus clinical isolates (from 14% in 2004 to 8% in 2014), an increasing trend in NmMRSA was observed. Variations in geographical distribution were noted, with a decrease in the proportion of MRSA in the Italian- and French-speaking regions (from 20–26% in 2004 to 12% in 2014) and low prevalence (3–5%) in the German-speaking region. We noticed an increase in the proportion of MRSA in outpatients (+0.03% per quarter per year) and in the younger population (+0.05% per quarter per year) compared with a decreasing trend in inpatients and the elderly.

CONCLUSION: The proportion of MRSA among S. aureus isolates in Switzerland decreased overall from 2004 to 2014. Worrisome increases of NmMRSA were found in younger persons and outpatients.


  1. Karchmer TB, Gianetta ET, Muto CA, Strain BA, Farr BM. A randomized crossover study of silver-coated urinary catheters in hospitalized patients. Arch Intern Med. 2000;160:3294–8.
  2. Chen CJ, Huang YC. New epidemiology of Staphylococcus aureus infection in Asia. Clin Microbiol Infect. 2014;20:605–23.
  3. Boyce JM, Cookson B, Christiansen K, Hori S, Vuopio-Varkila J, Kocagöz S, Oztop AY, et al. Meticillin-resistant Staphylococcus aureus. Lancet Infect Dis. 2005,5:653–63.
  4. Blanc DS, Pittet D, Ruef C, Widmer AF, Mühlemann K, Petignat C, Harbarth S, et al. Epidemiology of methicillin-resistant Staphylococcus aureus: results of a nation-wide survey in Switzerland. Swiss Med Wkly. 2002;132:223–9.
  5. Kronenberg A, Zanetti B, Piffaretti J, Mühlemann K. Antibiotikaresistenzdaten der Schweiz: jetzt online. Schweiz Med Forum. 2008,8:415–8.
  6. Vandenesch F, Naimi T, Enright MC, Lina G, Nimmo GR, Heffernan H, Liassine N, et al. Community-acquired methicillin-resistant Staphylococcus aureus carrying Panton-Valentine leukocidin genes: worldwide emergence. Emerg Infect Dis. 2003;9:978–84.
  7. Munckhof WJ, Nimmo GR, Carney J, Schooneveldt JM, Huygens F, Inman-Bamber J, Tong E, et al. Methicillin-susceptible, non-multiresistant methicillin-resistant and multiresistant methicillin-resistant Staphylococcus aureus infections: a clinical, epidemiological and microbiological comparative study. Eur J Clin Microbiol Infect Dis. 2008;27:355–64.
  8. Altman DG, Vergouwe Y, Royston P, Moons KG. Prognosis and prognostic research: validating a prognostic model. BMJ. 2009,338:b605.
  9. Vernaz N, Huttner B, Muscionico D, Salomon JL, Bonnabry P, Lopez-Lozano JM, et al. Modelling the impact of antibiotic use on antibiotic-resistant Escherichia coli using population-based data from a large hospital and its surrounding community. J Antimicrob Chemother. 2011,66:928–35.
  10. Dickey DA, Wayne A. Distribution of the estimators for autoregressive time series with a unit root. J Am Stat Assoc. 1979;74:427–31.
  11. Durbin J, Watson GS. Testing for serial correlation in least squares regression. I. Biometrika. 1950;37:409–28.
  12. Harbarth S, Albrich W, Goldmann DA, Huebner J. Control of multiply resistant cocci: do international comparisons help? Lancet Infect Dis. 2001;1:251–61.
  13. Filippini M, Masiero G, Moschetti K. Socioeconomic determinants of regional differences in outpatient antibiotic consumption: evidence from Switzerland. Health Policy. 2006;78:77–92.
  14. Harbarth S, Sprumont D, Francioli P. Recensement, surveillance et contrôle des infections dues au staphylocoque doré résistant à la méticilline («MRSA»): la déclaration doit-elle être rendue obligatoire? Swiss-NOSO 2007;13.
  15. Otter JA, Kearns AM, French GL, Ellington MJ. Panton-Valentine leukocidin-encoding bacteriophage and gene sequence variation in community-associated methicillin-resistant Staphylococcus aureus. Clin Microbiol Infect. 2010;16:68–73.
  16. Liassine N, Auckenthaler R, Descombes MC, Bes M, Vandenesch F, Etienne J. Community-acquired methicillin-resistant Staphylococcus aureus isolated in Switzerland contains the Panton-Valentine leukocidin or exfoliative toxin genes. J Clin Microbiol. 2004,42:825–8.
  17. Sax H, Posfay-Barbe K, Harbarth S, Francois P, Touveneau S, Pessoa-Silva CL, Schrenzel J, et al. Control of a cluster of community-associated, methicillin-resistant Staphylococcus aureus in neonatology. J Hosp Infect. 2006;63:93–100.
  18. Köck R, Becker K, Cookson B, van Gemert-Pijnen JE, Harbarth S, Kluytmans J, Mielke M, et al. Methicillin-resistant Staphylococcus aureus (MRSA): burden of disease and control challenges in Europe. Euro Surveill. 2010;15:19688.
  19. Harbarth S, Martin Y, Rohner P, Henry N, Auckenthaler R, Pittet D. Effect of delayed infection control measures on a hospital outbreak of methicillin-resistant Staphylococcus aureus. J Hosp Infect. 2000;46:43–9.
  20. Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, Perneger TV. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet. 2000;356:1307–12.
  21. Landelle C,, Marimuthu K, Harbarth S. Infection control measures to decrease the burden of antimicrobial resistance in the critical care setting. Curr Opin Crit Care. 2014;20:499–506.
  22. Deurenberg RH, Stobberingh EE. The evolution of Staphylococcus aureus. Infect Genet Evol. 2008;8:747–63.
  23. LaPlante KL, Rybak MJ, Amjad M, Kaatz GW. Antimicrobial susceptibility and staphylococcal chromosomal cassette mec type in community- and hospital-associated methicillin-resistant Staphylococcus aureus. Pharmacotherapy. 2007;27:3–10.
  24. De Angelis G, Francois P, Lee A, Schrenzel J, Renzi G, Girard M, Pittet D, Harbarth S. Molecular and epidemiological evaluation of strain replacement in patients previously harboring gentamicin-resistant MRSA. J Clin Microbiol. 2011;49:3880–4.
  25. C. Plüss-Suard AK, Kronenberg RA, Zanetti G and the Swiss Centre for Antibiotic Resistance. Antibiotic use in 61 acute care hospitals in Switzerland: trends over the years 2004–2012 and comparison with Europe. Joint Annual Meeting, Aarau, 2014.
  26. Graffunder EM, Venezia RA. Risk factors associated with nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection including previous use of antimicrobials. J Antimicrob Chemother. 2002;49:999–1005.
  27. Charbonneau P, Parienti JJ, Thibon P, Ramakers M, Daubin C, du Cheyron D, Lebouvier G, et al. Fluoroquinolone use and methicillin-resistant Staphylococcus aureus isolation rates in hospitalized patients: a quasi experimental study. Clin Infect Dis. 2006;42:778–84.

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