Methicillin-Resistant Staphylococcus aureus
Total Death Rate in EIP Surveillance Area
2.8
deaths per 100,000 people
Infections by Epidemiologic Classification (percentage of cases)
- Hospital-Onset:
- 15%
- Healthcare-Associated Community-Onset:
- 64%
- Community-Associated:
- 21%
Infection Rates by Race/Ethnicity (per 100,000 people)
- Hispanic or Latino, any race:
- 10.5
- Not known to be Hispanic or Latino
- Black or African American:
- 26.0
- White:
- 22.9
- Asian or Native Hawaiian/Other Pacific Islander:
- 7.8
- American Indian/Alaska Native or Multiracial:
- 10.8
MRSA Data Profile (EIP)
Methicillin-Resistant Staphylococcus aureus
The Emerging Infections Program tracks invasive methicillin-resistant S. aureus (MRSA) infections in selected areas of the United States. Invasive infections are serious infections that occur in certain internal body sites that are normally sterile, such as the bloodstream, bones or joints, deep tissues or organs.
Substantial exposures to a healthcare setting (e.g., hospitalization, surgery, dialysis, living in a nursing home or long-term care facility, having a central vascular catheter in place) can put people at increased risk for invasive MRSA infection. People with certain underlying health conditions may also be at increased risk for invasive MRSA infection.
Significant progress was made to reduce invasive MRSA infections associated with healthcare from 2005-2012 but declines in rates of invasive MRSA infection have slowed in recent years. Tracking and preventing invasive MRSA infections is a CDC priority.
- Data Source
- Emerging Infections Program (EIP)
- Years Included
- 2005 - 2023
- Resources
- MRSA Basics
- MRSA for Healthcare Providers
- Tracking Staph Infections
- MRSA Annual Reports
- HAIC Viz
- Healthcare-Associated Infections Data and Statistics
- National and State Healthcare-Associated Infections Progress Report
- FAQs about the HAI Progress Report
- Antibiotic Resistance Threats in the United States, 2019
Invasive MRSA Infections in EIP Sites
Invasive MRSA Infections in EIP Sites
All MRSA Cases
Note: Epidemiologic classification (epi class): A case is classified as Hospital-onset (HO) if the Staphylococcus aureus culture was obtained on or after the fourth calendar day of hospitalization, where admission is hospital day 1; Healthcare-associated community-onset (HACO) if the culture was obtained in an outpatient setting or before the fourth calendar day of hospitalization and had one of the following: 1) a history of hospitalization, surgery, dialysis or residence in a long-term care facility in the previous year or, 2) the presence of a central vascular catheter (CVC) within 2 days prior to culture; Community-associated (CA) if none of the previously mentioned criteria are met. Methods for this surveillance activity have changed over time. MRSA annual reports provide information about changes in methods from year to year. Surveillance areas have changed over time. Age categories for 1-17 years were combined starting in 2021; the two “View By” options for age reflect this change. Race data is included in the visualization through 2020. Starting in 2021, race and ethnicity were combined for analysis; race and ethnicity data for 2021-2023 are not visualized.
Invasive MRSA Infections in EIP Sites - Death Rates
Note: Epidemiologic classification: A case is classified as Hospital-onset if the Staphylococcus aureus culture was obtained on or after the fourth calendar day of hospitalization, where admission is hospital day 1; Healthcare-associated community-onset if the culture was obtained in an outpatient setting or before the fourth calendar day of hospitalization and had one of the following: 1) a history of hospitalization, surgery, dialysis or residence in a long-term care facility in the previous year or, 2) the presence of a central vascular catheter (CVC) within 2 days prior to culture; Community-associated if none of the previously mentioned criteria are met. Methods, such as the way missing data are taken into account, have changed over time. MRSA annual reports describe the specific methodology used each year. Surveillance areas have changed over time.
Invasive MRSA Syndromes
MRSA Syndromes
This graph shows the percentage of invasive MRSA cases by syndrome from 2005-2023.
All Syndrome Types
Note: Bloodstream infections with no other syndrome are cases who had a positive blood culture but no other clinical syndrome identified (e.g. pneumonia or meningitis). Methods, such as the way missing data are taken into account, have changed over time. MRSA annual reports describe the specific methodology used each year. Surveillance areas have changed over time.
Invasive MRSA PFGE Types
Percent of invasive MRSA by inferred pulsed-field gel electrophoresis (PFGE) type among isolates in HAIC surveillance area
Note: Pulsed field gel electrophoresis (PFGE) was discontinued in 2008; up until 2012, PFGE was inferred using a validated algorithm. From 2012-2016, spa typing was included in routine laboratory testing to assign MLST clonal complexes, and PFGE types were inferred based on MLST clonal complex and molecular characteristics of the isolates; USA300 isolates were confirmed using a single-nucleotide polymorphism (SNP) assay. Beginning in 2017, isolate testing included whole genome sequencing (WGS) to perform staphylococcal cassette chromosome mec (SCCmec) typing, spa typing, multilocus sequence typing (MLST), clonal complex assignment, SNP analysis, and inferred PFGE typing. Isolates are a convenience sample of total cases; surveillance areas for isolate collection have changed over time and are described in MRSA annual reports.
Footnotes
- Race and ethnicity categories: Starting in 2023, Bayesian Improved Surname Geocoding (BISG) was used to impute missing race/ethnicity. Race/ethnicity was considered missing if a patient had unknown ethnicity (regardless of reported race) or if a patient had unknown race and was not Hispanic or Latino. BISG applies Bayes’ Theorem to estimate a patient’s probability of belonging to each racial/ethnic group given their surname and home census tract or county. Probabilities for patients with known race/ethnicity were set to 1 for their reported race/ethnicity group and 0 for all other racial/ethnic groups. Race/ethnicity-stratified case counts were calculated by summing the probabilities for each racial/ethnic group. Note that a small proportion of patients with missing race/ethnicity who are multiracial (Asian and Native Hawaiian/Other Pacific Islander) may have been imputed as Non-Hispanic or Latino – Asian and/or Native Hawaiian/Other Pacific Island using the BISG method, which does not distinguish between these two racial/ethnic groups.
- Epidemiologic classification: A case is classified as Hospital-onset if the Staphylococcus aureus culture was obtained on or after the fourth calendar day of hospitalization, where admission is hospital day 1; Healthcare-associated community-onset if the culture was obtained in an outpatient setting or before the fourth calendar day of hospitalization and had one of the following: 1) a history of hospitalization, surgery, dialysis or residence in a long-term care facility in the previous year or, 2) the presence of a central vascular catheter (CVC) within 2 days prior to culture; Community-associated if none of the previously mentioned criteria are met.
- Death determination: For patients admitted to a hospital, vital status was assessed at the time of discharge. For patients that were in a long term care facility, long term acute care facility, or seen at an outpatient dialysis center, vital status was assessed 30 days after the date of incident culture. For all other patients, vital status was ascertained using medical records from the healthcare facility encounter associated with the incident culture.
- Note: MRSA annual reports describe the specific methodology used each year. Surveillance areas have changed over time.