Methicillin-resistant Staphylococcus aureus in German hospitals: individual- and regional-level predictors

Aim Nosocomial infections are an increasing risk worldwide, including in German hospitals. Methicillin-resistant Staphylococcus aureus (MRSA) infections are difficult to treat because of antibiotic resistances. The aim of this study is to gain insights into the relationship between MRSA and several characteristics of patients (individual level) and geographical regions (regional level). Subjects and methods Based on the German Diagnosis Related Groups Hospital Statistics (DRG Statistics), an analysis of secondary data relating to individual and regional predictors was conducted for the year 2011. The data set included 1.6 million cases (10 % sample), and the analysis was carried out using descriptive as well as inductive statistical methods including multilevel analysis. Results The variables age, male sex and length of hospital stay (individual level) as well as a higher prevalence of antibiotic prescriptions, a higher age structure in the population and a higher number of beds per hospital (regional level) are significantly associated with the probability of MRSA. The analysis does not reveal significant effects of the share of male population or the share of private hospitals. Conclusion The identified predictors related to MRSA will perhaps have an effect on the German health system in the future. Due to demographic changes, an increasing average age in the population may lead to a higher number of MRSA cases. Consequently, the financial burden on the insurance system will rise. Hence, MRSA prevention strategies and legal regulations should be taken more seriously in the next years.