Risk factors for infection with MRSA

A patient with one or more of the risk factors below is at increased risk of methicillin-resistant Staphylococcus aureus (MRSA) infection. However, patients at increased risk will not necessarily be colonised or infected with MRSA.

Consider whether to modify empirical therapy on an individual patient basis, taking into account the severity of infection. Culture results are particularly important to guide ongoing therapy.

Risk factors for infection with MRSA include:

• residence in an area with a high prevalence of MRSA (eg Northern Territory; remote communities in northern Queensland; regions north of metropolitan Perth in Western Australia, especially the Kimberly and Pilbara)Harch, 2017Macmorran, 2017Tong, 2015
• previous colonisation or infection with MRSA, particularly if recent or associated with the current episode of care [NB1]
• frequent stays, or a current prolonged stay, in a hospital with a high prevalence of MRSA, particularly if associated with antibiotic exposure or recent surgery
• residence in an aged-care facility with a high prevalence of MRSA, particularly if the patient has had multiple courses of antibiotics
• current residence, or residence in the past 12 months, in a correctional facilityHaysom, 2019Haysom, 2018Marschall, 2006Scanvic, 2001
• current injecting drug use or injecting drug use in the past 6 months.Curtis, 2024

If modifying empirical therapy based on the presence of risk factors, consider local MRSA epidemiology and susceptibility patterns (particularly of community-associated MRSA).