National MRSA rates run along with fair play of national football teams: a cross-national data analysis of the European
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BRIEF REPORT
National MRSA rates run along with fair play of national football teams: a cross-national data analysis of the European Football Championship, 2008 E. Meyer • P. Gastmeier • F. Schwab
Received: 25 May 2012 / Accepted: 23 July 2012 / Published online: 5 August 2012 Ó Springer-Verlag 2012
Abstract Background We aimed to assess the relationship between national methicillin-resistant Staphylococcus aureus (MRSA) proportions and indicators for fair play in the European Football Championship, 2008. Finding We obtained methicillin resistance data for S. aureus from the European Antimicrobial Resistance Surveillance System (EARSS) project. All teams which qualified for the final tournament and had reported data to the EARSS were included in the analysis. Hosting countries were excluded. The number of yellow and red cards was calculated per 100 min as an indicator for fair play. Red cards were weighted like yellow cards. We calculated correlations between antibiotic resistance and use using two-tailed Spearman’s coefficient (r) for non-parametric correlations. In 2008, 16 countries qualified for the European Football Championship. Five countries (Turkey, Switzerland, Croatia, Russia and Austria) did not report MRSA data to the EARSS and/or were hosting countries. The correlation of national MRSA proportions and the fair play indicator was highly significant (p = 0.038), with a correlation coefficient of 0.632. Conclusion This study shows that national MRSA proportions increase with more unfair play of the national teams: Sweden and the Netherlands played the fairest and had the lowest MRSA proportions. However, it remains to be proven (e.g. in the European Football Championship, 2012) whether this fair play indicator, indeed, can serve as
E. Meyer (&) P. Gastmeier F. Schwab Institute of Hygiene and Environmental Medicine, Charite´—University Medicine Berlin, Hindenburgdamm 27, 12203 Berlin, Germany e-mail: [email protected]
an indicator for adherence with MRSA guidelines or whether this correlation cannot be substantiated. Keywords Football Soccer MRSA Adherence Guidelines Fair play indicator
Background The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) varies tremendously between countries [1]. In Europe, high proportions of MRSA have been recorded in southern Europe and England, whereas Scandinavian countries like Norway are only marginally affected. The reasons for the uneven geographical distribution of MRSA—almost stopping at national borders—are widely discussed and mainly explained by differences in infection control policies (e.g. search and destroy in the Netherlands) and compliance with guidelines on appropriate antibiotic therapy and prophylaxis of infections. Some studies suggest a relationship between bacterial resistance and the volume of antibiotics consumption [2, 3]. Deschepper et al. argued that cross-national differences in antibiotics consumption can only be partially explained by the above-mentioned epidemiological differences or variation in h
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