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During a 3 1/2-year period (January 1978 through June 1981), 245 patients in a university hospital became colonized or infected with methicillin-resistant Staphylococcus aureus. During the first 18 months, the incidence of colonization and infection was only 0.05%. After a focal outbreak of methicillin-resistant S aureus in the burn unit, acquisition of the organism by patients on other wards increased significantly. Nonburn patients acquired the organism more often during time periods when newly admitted burn patients acquired methicillin-resistant S aureus. After the burn unit was closed, acquisition of the organism among nonburn patients on adult surgical and medical services decreased significantly. A questionnaire survey of other institutions disclosed that large outbreaks of this infection occurred more frequently in hospitals with burn units. These studies suggest that the occurrence of methicillin-resistant S aureus infections in burn units may lead to increased transmission of the organism to nonburn patients and that control of the infection in such units may reduce spread of the organism to patients without burns.

Although several outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) infections have been reported in recent years, the geographic distribution and frequency of MRSA infections in American hospitals is unknown. We conducted a questionnaire survey to determine the magnitude of the problem. Data from 261 hospitals were included in the survey. MRSA were reported by 145 hospitals located in 36 states. Large hospitals reported these organisms significantly more often than small hospitals (p less than .001). University hospitals reported MRSA more often than community or community-teaching hospitals (p less than .001 and p less than .005, respectively). The number of hospitals reporting MRSA increased from 24 in 1975 to 112 in 1980 (p less than .001. Our data suggest that MRSA are widely distributed geographically and that the number of hospitals with these organisms has increased dramatically since 1975.