Combating MRSA; combining and increasing our understanding on colonisation, transmission and reservoirs will lead to control of infections by MRSA

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The underlying reasons for the epidemiological dynamics of MRSA clones in the hospital and the community are debated intensely and different explanations can be controversial. Most studies focus either on the genetic basis of the ability of MRSA to spread and be sustained, like the presence of PVL, SCCmec type IV etc. or on the epidemiological features, like risk groups, selection due to antibiotic use, or prevention measures in health care centres. After introduction of new strains, antibiotic or disinfectant use is an important driving force, prevention should be focused on that point. When selected strains are more able to spread due to their genetic profile, measures should be developed targeted on prevention of transmission of these particular strains. However, a combination of driving forces will be often present. In short, this study will create more insight into the success and failure of MRSA, and together with the mathematical model, will target specific and realistic tools to prevent further spreading and thus disease. This accounts both for hospitalized patients and in otherwise healthy individuals, as present in the large uncontrolled epidemic by USA300. MACOTRA will join approaches on understanding the epidemiology of MRSA together, will add the host-factor and herewith aims to explain the epidemiological behaviour of MRSA in its rise, maintenance or disappearance. We believe that only by combining all these aspects, we can understand the epidemiology and thus design optimal and focused prevention measures.