Understanding Shifts in Staphylococcal Resistance

A decade-long surveillance review at a single orthopedic and trauma hospital documents a large fall in MRSA rates from 66.3% in 2012 to 28.6% in 2024, indicating a substantial reduction in local burden and measurable progress in infection control.

This retrospective surveillance analysis of routine clinical specimens (2012–2024) evaluated MRSA proportion and broader susceptibility trends across 17,202 samples with 2,286 Staphylococcus-positive cultures (13.3%).

Specimen volumes notably decreased during the COVID period, yet the proportion of specimens positive for Staphylococcus spp. remained stable, indicating persistence of these organisms in the hospital ecosystem despite reduced sampling. Reduced specimen numbers therefore did not obscure organism's presence or the overall susceptibility signal, so surveillance trends remained interpretable through the pandemic's disruptions.

Resistance in coagulase-negative staphylococci (CoNS) is increasing, particularly in orthopedic specimens, which raises concern for prosthetic- and device-associated infections and for empiric antibiotic selection in orthopedic practice.

Taken together, the high-confidence findings—marked MRSA decline, rising CoNS resistance, and stable detection despite fewer specimens—support prioritization of focused surveillance, reappraisal of empiric-choice algorithms where device infections are common, and continued emphasis on core infection-control measures rather than wholesale protocol changes.

Key Takeaways:

• MRSA rates fell from 66.3% in 2012 to 28.6% in 2024 (single-center orthopedic/trauma surveillance), reducing empiric MRSA risk and supporting recalibration of empiric therapy thresholds.
• Pandemic-era specimen volumes decreased, but Staphylococcus spp. detection rates remained stable, indicating surveillance signals stayed interpretable despite lower sampling and supporting continued reliance on longitudinal local data.
• Coagulase-negative staphylococci resistance is increasing in orthopedic specimens, implying the need for targeted susceptibility testing and stewardship adjustments for device- and prosthesis-associated care.