SPECIAL TOPICS

Methicillin-Resistant Staphylococcus aureus (MRSA)

March 2008
 

The baseline time span for this database is 1997-October 31, 2007 (fifth bimonthly period in 2007). The resulting database contained 6,095 (10 years) and 2,451 (2 years) papers; 18,673 authors; 109 countries; 914 journals; and 4,580 institutions.

OVERVIEW

Methicillin-resistant Staphylococcus aureus (MRSA) is a topic of increasing concern in the realm of healthcare. MRSA was one of the first bacteria to develop resistance to drugs. S. aureus is actually present in abundance in the human body, but when introduced to an immunocompromised patient, it can be very severe. Because of this, MRSA can be particularly alarming in hospital and healthcare settings, resulting in longer hospital stays, more expensive, less effective, and possibly more toxic treatments, and even death. According to the Centers for Disease Control, in 1974 MRSA accounted for 2% of staph infections; by 1995 that number had increased to 22%, and in 2004, it was a whopping 63%.

This month, Special Topics looks at the progress of research on MRSA over the past decade and over the past two years. Highlights of the field over the past decade include genome sequencing, the association of MRSA with Panton-Valentine leukocidin gene markers, epidemiological studies in various settings and communities, studies on compliance with hygiene in hospitals, guidelines for management, virulence determinants, case reports, and a meta-analysis of mortality rates. The gravity of MRSA's resistance becomes ever more clear with papers showing further resistance to other drugs, including vancomycin, and, in one instance, linezolid.

Over the past two years, the research aspects are similar to those from the past decade, but with a more specific focus. Genome sequencing studies now include the complete genome sequence of the epidemic USA 300 MRSA clone. Epidemiology studies, particularly of skin and soft tissue infections in emergent care settings, are also narrowed to specific MRSA clones, and the USA 300 clone plays a prominent role. Clinical trials include studies of community-acquired MRSA in children, necrotizing fasciitis resulting from community-acquired MRSA, staph-induced endocarditis, MRSA abscesses in players and employees of the St. Louis Rams football team, and the SOAP trial of sepsis in European ICU's. One trial compared linezolid and vancomycin for the treatment of MRSA infections, whereas another showed strains of MRSA that are now resistant to vancomycin. An experimental study using the new drug platensimycin is also reported.

Methodology: To construct this database, papers were extracted based on title- and author-supplied keywords for Methicillin-Resistant Staphylococcus aureus (MRSA). The keywords used were as follows:

("methicillin resistant Staphylococcus aureus" OR "methicillin resistant S aureus" OR "MRSA" OR "methicillin resist*")

The baseline time span for this database is 1997-October 31, 2007 (fifth bimonthly period in 2007). The resulting database contained 6,095 (10 years) and 2,451 (2 years) papers; 18,673 authors; 109 countries; 914 journals; and 4,580 institutions.

Rankings: Once the database was in place, it was used to generate the lists of top 20 papers (two- and ten-year periods), authors, journals, institutions, and nations, covering a time span of 1997-October 31, 2007 (fifth bimonthly, a 10-year plus 10-month period).

The top 20 papers are ranked according to total cites. Rankings for author, journal, institution, and country are listed in three ways: according to total cites, total papers, and total cites/paper. The paper thresholds and corresponding percentages used to determine scientist, institution, country, and journal rankings according to total cites/paper, and total papers respectively are as follows: