Staphylococcus aureus: guidance, data and analysis

The characteristics, diagnosis, management, surveillance and epidemiology of Staphylococcus aureus.

Staphylococcus aureus (S. aureus) is a bacterium that commonly colonises human skin and mucosa without causing any problems. It can also cause disease, particularly if there is an opportunity for the bacteria to enter the body, for example through broken skin or a medical procedure.

If the bacteria enter the body, illnesses which range from mild to life-threatening may then develop. These include skin and wound infections, infected eczema, abscesses or joint infections, infections of the heart valves (endocarditis), pneumonia and bacteraemia (blood stream infection).

Most strains of S. aureus are sensitive to the more commonly used antibiotics, and infections can be effectively treated. Some S. aureus bacteria are more resistant. Those resistant to the antibiotic meticillin are termed meticillin resistant Staphylococcus aureus (MRSA) and often require different types of antibiotic to treat them. Those that are sensitive to meticillin are termed meticillin susceptible Staphylococcus aureus (MSSA). MRSA and MSSA only differ in their degree of antibiotic resistance: other than that there is no real difference between them.

Diagnosis and management

  1. Who to screen for MRSA
  2. MRSA in patients with renal failure


PHE has carried out mandatory enhanced surveillance of MRSA bacteraemia since October 2005 and of MSSA bacteraemia since January 2011 for NHS acute trusts; patient-level data of any MRSA and MSSA bacteraemias are reported monthly to PHE. Independent sector (IS) healthcare organisations providing regulated activities also undertake surveillance of MRSA and MSSA bacteraemia.

Between 1 April 2013 and 31 March 2018, all positive cases of MRSA bacteraemia were subject to a Post Infection Review (PIR), carried out by the reporting NHS Acute trust and attributable Clinical Commissioning Group. From 1 April 2018 this process is no longer mandatory for all cases and is instead replaced by formal local reviews of MRSA cases for those Trusts and CCGs with the highest MRSA rates. The updated NHS Improvement guidance on MRSA Post Infection Review which can be found here

  1. MRSA bacteraemia: monthly data by location of onset
  2. MSSA bacteraemia: monthly data by location of onset
  3. MRSA bacteraemia: annual data
  4. MSSA bacteraemia: annual data
  5. Staphylococcus aureus: annual trends in voluntary surveillance
  6. MRSA, MSSA and Gram-negative bacteraemia and CDI: annual report
  7. MRSA, MSSA, Gram-negative bacteraemia and CDI: quarterly report
  8. MRSA, MSSA, Gram-negative bacteraemia and CDI: independent sector
  9. MRSA, MSSA, Gram-negative bacteraemia and CDI; independent sector
  10. MRSA, MSSA, Gram-negative bacteraemia and CDI: 30-day all-cause fatality

Official statistics compliance

We produce Healthcare associated infections (HCAI) mandatory surveillance statistics publications in accordance with the code of practice for official statistics and they are designated as National Statistics. The data-specific documents below describe our compliance with aspects of the Code.

User engagement

The stakeholder engagement summary collates evidence from mandatory HCAI surveillance statistics users and provides:

  • a summary of how the statistics are used
  • views on how provision of the statistics meets the needs of users
  • our actions in response to user feedback

We will update this document as we receive further user feedback.

Read minutes of the HCAI Mandatory Surveillance Stakeholder Engagement Forum.

Published 9 July 2014
Last updated 2 February 2017 + show all updates
  1. Updated with links to the 6 June 2016 meeting.
  2. Added MRSA, MSSA and E. coli bacteraemia and C. difficile infection: 30 day all-cause fatality to collection.
  3. First published.