Background Infections with multiresistant Gram negative pathogens are rising around the world, but many European countries have recently seen a decline in infections due to methicillin resistant (MRSA). 30% for lower respiratory tract infections. Regression analysis revealed significantly lower MRSA fractions in the German states of Brandenburg (odds ratio [OR] 0.41), Bavaria (OR 0.73), and Saxony-Anhalt (OR 0.53), with higher fractions in Berlin (OR 1.59), Mecklenburg-West Pomerania (OR 1.91), Lower Saxony (OR 1.85), and North Rhine-Westphalia (OR 1.55). There were no significant differences in the remaining German states. Conclusion In Germany, the percentage of nosocomial infections due to MRSA dropped significantly over the period 2007C2012. The causes of this decline are unclear; it may have resulted from human intervention, pathogen biology, or both. Cases of infection with methicillin resistant (MRSA) have decreased worldwide in recent years (1C 3). Recent data from the US showed a reduction of 31% in invasive MRSA infections over a period of seven years (2005C2011) (1). In the United Kingdom, where MRSA bacteremia has been a notifiable disease for a long time, the drop in rates has been even more dramatic, at 69%. The number of cases of MRSA bacteremia fell from 2935 in 2008/2009 to 924 in 2011/2012 (2). In French hospitals in the Paris region, the rate of MRSA infections dropped by 35% between 1993 and 2007this reflects the proportion of MRSA among all strains of (from 41% to 26.6%) as well as the incidence of MRSA (from 0.86/1000 patient days to 0.56/1000 patient days (3). In most countries in the European Union, the proportion of MRSA among invasive infections is stagnating, or even falling significantly. It is a well known fact that within Europe, resistance rates in MRSA are subject to wide variation, with high rates in the south and comparatively low rates in the Netherlands and Scandinavia (4). Such regional differences exist not only between individual countries but also within countries. In the US, for example, the prevalence of MRSA within individual states ranges from 0/1000 patients in South Dakota to 110.8/1000 patients in Texas, and it generally seems lower in the northwest than in the southeast (5). In Switzerland the boundary coincides with the so called ditch, the language border between the German speaking and Francophone parts of Switzerland. In Francophone Switzerland, the proportion of MRSA among all laboratory isolated strains of was 17.5% in 2012, whereas in the German speaking BMS564929 supplier east of the country it was only 4.7% BMS564929 supplier (6). MRSA strains are still common multiresistant pathogens, even though multiresistant Gram negative pathogens are on the increase (7C 11). This study aimed to investigate in a large network of hospitals whether Germany is also subject to wide regional differences in MRSA and whether the proportion of MRSA among nosocomial infections has changed in Germany over the past six years. Method The Rabbit Polyclonal to MRPL11 Hospital Infection Surveillance System (KISS) has been in existence BMS564929 supplier since 1997 and includes data on selected nosocomial infections in different risk areas, such as intensive care units or surgical wards. Participation in the scheme is voluntary, and individual participants data are strictly confidential. The fact that participation is voluntary explains the fact that over the years, the numbers of intensive care wards and BMS564929 supplier surgical wards have varied (12, 13). The data collection was done on the basis of a uniform protocol, which also included commitments and definitions from the National Healthcare BMS564929 supplier Safety Network (NHSN) of the Centers for Disease Control and Prevention (CDC). Surveillance of nosocomial infections and their pathogens in intensive care wards (ITS-KISS) Information on the development of a nosocomial infection of the lower respiratory tract, primary sepsis, or urinary tract infection is collected for all intensive care patients. The diagnosis is made on the basis of set definitions, whichdepending on the type of infectioninclude combinations of microbiological and/or radiological findings in combination with clinical signs of infection (14). For each case of nosocomial infection, further variables are documented, such as confirmed pathogens, date of infection, and temporal association of the infection with devices (tracheal tube, central venous catheter, urinary catheter). Surveillance of postoperative wound infections and their pathogens (OP-KISS) Data on wound infections after commonly performed or particularly relevant surgical proceduresso called indicator operationsare collected from participating surgical wards. The data of operated patients are followed up postoperatively until discharge, in the entire hospital. The following data are documented for.