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Control of methicillin-resistant Staphylococcus aureus in Canadian paediatric institutions is still a worthwhile goal.

Control of methicillin-resistant Staphylococcus aureus in Canadian paediatric institutions is still a worthwhile goal In both Europe and the United States, the presence of methicillin-resistant Staphylococcus aureus (MRSA) in hospitalized patients is no longer a sporadic occurrence, and MRSA has become an endemic problem in many institutions (1). Fortunately, in most health care facilities in Canada, the presence of MRSA is still sporadic. However, MRSA outbreaks in health care facilities and the presence of MRSA in the community indicate that Canadian hospitals are at risk of having MRSA introduced into their facilities (2,3). A recent cross-Canada MRSA surveillance study of 21 hospitals noted an increase in the proportion of isolates that are methicillinresistant (1.2% in 1995 compared with 2.3% in 1996), with most isolates originating in Ontario and Quebec (4). The proportion of methicillin-resistant isolates continues to increase; from 1995 to 1998, MRSA accounted for 3.4% of the S aureus isolates collected from across Canada. Given that the overall numbers remain relatively low, prevention of MRSA infection in patients hospitalized in Canada should be an achievable goal, if appropriate measures are taken. The purpose of this statement is to provide an approach to control MRSA. MRSA is a good example of the phenomenon of natural selection. It has been seen repeatedly that soon after a new antibiotic comes into use, S aureus develops resistance to the antibiotic while maintaining its pathogenic characteristics. Table 1 demonstrates the chronology of the antimicrobial resistance of S aureus.