I recently had a review published in CMI comparing EU guidelines for controlling multidrug-resistant Gram-negative bacteria (MDR-GNB). I included the following guidelines in my review: ECCMID 2014, Irish MDRO, PHE CPE, HPS CPE, ECDC systematic review on CPE (not strictly a guideline, but did include some recommendations). A couple of important points arise:
A remarkable study published by a German group found that countries whose national football team performed badly on a fair play indicator had a higher proportion of methicillin-resistance amongst bloodstream isolates. The team investigated the countries who qualified for the 2008 European Football Championship and gave each a ‘fair play indicator’ score (red or yellow cards / 100 min). They then used methicillin resistance data for S. aureus from the European Antimicrobial Resistance Surveillance System (EARSS) programme to plot against the fair play indicator score. The proportion of S. aureus resistant to methicillin correlated with the fair play indicator score (correlation coefficient of 0.632, p=0.038). Greece, Turkey, Italy and Romania clustered together with a high proportion of MRSA and a poor fair play indicator score. The Netherlands and Sweden had a low MRSA rate and a better fair play indicator score.
Does this study highlight cultural differences that influence the national rate of MRSA? Or is this a statistical fluke? Repeating the approach on past or future European challenges (or perhaps even broadening the net to the Football World Cup) will help to confirm the association. But either way, it’s a great study for a football fan!
Article citation: Meyer E, Gastmeier P, Schwab F. National MRSA rates run along with fair play of national football teams: a cross-national data analysis of the European Football Championship, 2008. Infection 2012 Aug 5. [Epub ahead of print]