Methicillin-resistant Staphylococcus aureus, Hawaii, 2000-2002

The emergence of methicillin-resistant Staphylococcus aureus (MRSA) has generated considerable concern among medical and public health professionals. We used a statewide, population-based antimicrobial resistance surveillance system to examine epidemiologic trends for MRSA from outpatients and inpatients in Hawaii. Pediatric and adult patient populations were compared to assess characteristics of MRSA isolates specific for each group. From 2000 to 2002, 8,206 (26%) of 31,482 total S. aureus isolates were MRSA. During this period, the proportion of MRSA isolates increased in both outpatient and inpatient clinical settings (p < 0.01). When stratified by age, annual trends showed a significant increase in the proportion of MRSA in adult patients (from 24% to 30%, p < 0.01) but not in pediatric patients (from 25% to 27%, p > 0.05). Although MRSA isolates from adults demonstrated high resistance to most non-beta-lactams, most MRSA isolates from pediatric outpatients remained susceptible to most non-p-lactams.