Methicillin-resistant Staphylococcus aureus (MRSA) is currently the leading cause of mortality attributable to antimicrobial resistance in the world. Colonized persons are often asymptomatic but are able to spread the bacterium to others, both in the community and in healthcare settings. Besides, MRSA colonization increases (severe) infection risks. In the Netherlands, we have one of the world’s lowest rates of MRSA, which is to a large part ascribed to our ‘search and destroy’ policy. The policy consists of screening and preemptive isolation of patients at risk for MRSA carriership when hospitalized, and subsequent decolonization treatment when persistent carriership is found. However, the optimal strategy to decolonize individuals and to contain the policy outside hospital settings, is unclear. We study the most effective MRSA decolonization regimens, the uptake of the search and destroy policy, and the differences between high- and low endemic settings.
A severe complication of Staphylococcus aureus carriership is bloodstream infection. S. aureus is the leading cause of mortality by bloodstream infections, with a 90-day mortality of 25-30%. Several risk factors for mortality have been reported in literature, such as increasing age and hemodialysis dependence. Previous work from our group identified female sex as an additional risk factor for mortality. Furthermore, we showed that females with S. aureus bloodstream infection receive less optimal diagnostic and therapeutic interventions compared to males. Yet the mechanisms underlying this gender disparity remain unclear. Our current and future work aims to identify the underlying reasons for these sex-based differences in S. aureus bloodstream infection, and to further address the impact of sex in bloodstream infection due to other species. Identifying the underlying reasons is challenging but essential, as this may create opportunities for improved care and more individualized approaches in both females and males.
