Number of death certificates mentioning Staphylococcus aureus by methicillin resistance, England & Wales (number of deaths)
The number of death certificates mentioning Staphylococcus aureus (S.aureus) infection increased each year from 1993 to 2003 in England and Wales. The increase in the number of death certificates specifying MRSA accounted for all of this increase.
Between 2002 and 2003 mentions of MRSA on death certificates increased by 19 per cent but laboratory reports of MRSA compiled by the Health Protection Agency only show an increase of 7 per cent. This indicates that some of the recent increase in mentions of MRSA on death certificates may be due to improved levels of reporting, possibly brought about by the increased public profile of the disease.
Age-standardised rates for deaths involving S.aureus and MRSA were highest in males The rates for both males and females increased over the period 1993 to 2003. The age-standardised rate for deaths involving MRSA in males increased from 14.8 per million population in 2002 to 16.3 per million in 2003. In females the rate increased from 7.0 to 8.5 per million population over the same period.
Most of the deaths involving S.aureus or MRSA were in the older age groups. In 2003 mortality rates for deaths involving MRSA - in the 85 and over age group - were 437.1 and 220.8 deaths per million of the population for males and females respectively. In the under 45 age group there were 0.9 deaths per million among males, and 0.6 deaths per million population for females.
Methicillin-resistant Staphylococcus aureus (MRSA) is a variety of Staphylococcus aureus that is resistant to methicillin, and some of the other antibiotics that are usually used to treat S. aureus. Those who die with MRSA are usually patients who were already very ill and their existing illness, rather than MRSA, is often designated as the underlying cause of death. There is therefore an interest in the number of deaths where MRSA contributed to the death.
The method used to calculate the number of deaths involving MRSA is described in Griffiths C, Lamagni TL, Crowcroft NS, Duckworth G and Rooney C (2004) Trends in MRSA in England and Wales: analysis of morbidity and mortality data for 1993-2002. Health Statistics Quarterly 21, 15-22
Health Protection Agency 'Staphylococcus aureus bacteraemia laboratory reports and methicillin susceptibility (voluntary reporting scheme): England and Wales, 1990 – 2003' [15 July 2004]