NAVY AND MARINE CORPS PUBLIC HEALTH CENTER PORTSMOUTH VA PORTSMOUTH United States
The EpiData Center EDC conducts routine surveillance of methicillin-resistant Staphylococcus aureus MRSA incidence and prevalence among all beneficiaries seeking care within the Military Health System MHS. This report describes demographics, clinical characteristics, prescription practices, and antibiotic resistance patterns observed for MRSA in calendar year CY 2015. Multiple data sources were linked to assess descriptive and clinical factors related to MRSA. Health Level 7 HL7-formatted microbiology data identified S. aureus infections resistant to oxacillin, cefoxitin, or methicillin. These infections were matched to HL7-formatted pharmacy data to assess prescription practices, the Standard Inpatient Data Record SIDR to determine healthcare-associated exposures, Defense Manpower Data Center DMDC rosters to determine burden among Department of Defense DOD active duty AD service members, and the DMDC Contingency Tracking System CTS to determine Department of the Navy DON deployment-related infections. Overall, incidence rates of MRSA in the general United States US, MHS beneficiary, and DOD AD populations are decreasing. Inducible clindamycin resistance is slowly increasing in the MHS no additional changes in antibiotic susceptibility emerged in 2015. Clindamycin, trimethoprimsulfamethoxazole, doxycycline, and vancomycin remain viable treatments for MRSA, although clindamycin should be used cautiously in the inpatient setting due to reduced efficacy. Current infection control practices appear effective and continued surveillance is recommended.