Most nosocomial MRSA is multidrug resistant. They tend to colonize and infect patients during hospitalization or stays in long-term care facilities, after surgery or after contact with persons who had an MRSA infection or used illicit drugs. In the 1970s, periodic outbreaks were described in various parts of the world, in association with high levels of oxacillin or methicillin use and in intensive care environments, but since the 1980s, MRSA became a significant worldwide problem, first in large hospitals and later in smaller community hospitals.
Nosocomial MRSA is a growing problem in the region. Information gathered in the PAHO-sponsored program of nosocomial infections (PAHO 2006), reported for the year 2004, country MRSA prevalence as follows: Argentina 42.5% of 5851 isolates, Bolivia 36% of 1167, Chile 80% of 246, Colombia 47% of 4214, Costa Rica 58% of 674, Cuba 6% of 80, Ecuador 25% of 1363, Guatemala 64% of 1483, Honduras 125 of 393, Mexico 52% of 497, Nicaragua 20% of 296, Paraguay 44% of 980, Peru 80% of 1407, Uruguay 59% of 1431, and Venezuela 25% of 2114. Data reported to the Pan-American Association of Infectious Diseases for the year 2006 (Casellas and API Comité; Resistencia Antibacterianos 2006) demonstrated the following rates of resistance of hospital-acquired MRSA: Argentina 51%, Bolivia 55%, Brazil 54%, Chile 29%, Ecuador 25%, Mexico 32%, Panama 28%, Paraguay 30%, Uruguay 24%, and Venezuela 27%.
Molecular epidemiology of the spread of MRSA in Latin America has been evaluated, and three predominant clones have been identified in the region: the Brazilian clone (Sader et al. 1994) that has spread to Argentina (Da Silva Coimbra et al. 2000), the Pediatric clone (Gomes et al. 2001), and a clone from Cordoba, Argentina (Sola Gribaudo Vindel et al 2002). Additional clones have circulated in the area, including the Chilean clone in Colombia and
Paraguay (Cruz et al. 2005) and the New York/Japanese clone in both Brazil and Mexico (Melo et al. 2004)
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