Staphylococcus Aureus 
Annual Summary of Reportable Diseases

Staphylococcus aureus is a bacteria, which typically isn’t harmful, however in some cases can cause infections. In healthcare settings S. aureus infections can be serious or fatal, particularly infections that spread to the bloodstream, lungs, heart, or bone. 

In 2005, as part of the EIP Active Bacterial Core surveillance (ABCs) population-based surveillance of invasive methicillin-resistant S. aureus (MRSA) was initiated in Ramsey County; surveillance was expanded to include Hennepin County in 2008. The incidence rate was 14.6 per 100,000 in 2022 compared to 15.8 per 100,000 population in 2021. In 2022, MRSA was most frequently isolated from blood (84%, 221/263), and 13% (35/263) of the cases died in the hospital. The median age for all cases was 62 years (range, <1 to 97). 

In August 2014, as part of the EIP ABCs program, population-based surveillance of invasive methicillin-susceptible S. aureus (MSSA) was initiated in Hennepin and Ramsey Counties. The incidence rate was 31.9 per 100,000 in 2022 compared to 29.5 per 100,000 population in 2021. In 2022, MSSA was most frequently isolated from blood (81%, 467/574), and 12% (69/574) of the cases died in the hospital. The median age for all cases was 61 years (range, <1 to 94). 

Vancomycin-intermediate S. aureus (VISA) and vancomycin-resistant S. aureus (VRSA) are reportable in Minnesota, as detected and defined according to Clinical and Laboratory Standards Institute approved standards and recommendations: a minimum inhibitory concentration (MIC)=4-8 μg/ml for VISA and MIC≥16 μg/ml for VRSA. Patients at risk for VISA and VRSA generally have underlying health conditions such as diabetes and end stage renal disease requiring dialysis, previous MRSA infections, recent hospitalizations, and recent exposure to vancomycin. There have been no VRSA cases in Minnesota (MN). There were no VISA cases reported in 2022. Between 2008 and 2022, we confirmed 19 VISA cases; 2008 (3), 2009 (3), 2010 (2), 2011 (5), 2013 (3), 2016 (2), and 2019 (1). Among all cases of VISA in MN, 11 (58%) were male and the median age was 64 years (range, 27 to 86). Of those cases with known history (18), 89% reported recent exposure to vancomycin.

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Invasive Staphylococcus aureus (SA) infections are classified into one of three categories: hospital-onset (HOSA); healthcare-associated, community-onset (HACO-SA); and community-associated (CA-SA). SA must be isolated from a normally sterile body site greater than three days after the date of initial hospital admission for a case to be considered HO-SA. HACO-SA cases have at least one healthcare-associated (HA) risk factor identified in the year prior to infection. Examples of HA risk factors include residence in a long-term care facility, recent hospitalization(s), dialysis, presence of an indwelling central venous catheter, and surgery. CA-SA cases do not have any identifiable HA risk factors present in the year prior to infection. 

In 2005, as part of the Emerging Infections Program (EIP) Active Bacterial Core surveillance (ABCs) population-based surveillance of invasive methicillin-resistant S. aureus (MRSA) was initiated in Ramsey County. Surveillance was expanded to include Hennepin County in 2008. The incidence rate was 15.8 per 100,000 in 2021 compared to 14.8 per 100,000 population in 2020. In 2021, MRSA was most frequently isolated from blood (88%, 250/286), and 15% (43/286) of the cases died in the hospital. HACO-MRSA cases comprised the majority (61%, 175/286) of invasive MRSA infections in 2021, CA-MRSA cases accounted for 27% (76/286) and 12% (35/286) cases were HO-MRSA. The median age for all cases was 50 years (range, 3 to 98); the median age was 53 (range, 3 to 98), 52 (range, 9 to 89), and 43 (range, 3 to 93) for HO-, HACO-, and CA-MRSA cases, respectively. 

In August 2014, as part of the EIP Active Bacterial Core surveillance (ABCs) population-based surveillance of invasive methicillin-sensitive S. aureus (MSSA) was initiated in Hennepin and Ramsey Counties. The incidence rate was 29.5 per 100,000 in 2021 compared to 30.6 per 100,000 population in 2020. In 2021, MSSA was most frequently isolated from blood (80%, 425/533), and 11% (60/533) of the cases died in the hospital. HACO-MSSA cases comprised the majority (54%, 291/533) of invasive MSSA infections in 2021, CA-MSSA cases accounted for 35% (189/533) and 10% (53/533) cases were HO-MSSA. The median age for all cases was 58 years (range, <1 to 97); the median age was 61 (range, 4 to 97), 54 (range, <1 to 78), and 53 (range, 2 to 97) for HO-, HACO-, and CA- MSSA cases, respectively. 

Vancomycin-intermediate S. aureus (VISA) and vancomycin-resistant S. aureus (VRSA) are reportable in Minnesota, as detected and defined according to Clinical and Laboratory Standards Institute approved standards and recommendations. These recommendations stipulate a minimum inhibitory concentration (MIC)=4-8 μg/ ml for VISA and MIC≥16 μg/ml for VRSA. Patients at risk for VISA and VRSA generally have underlying health conditions, such as diabetes and end stage renal disease requiring dialysis, previous MRSA infections, recent hospitalizations, and recent exposure to vancomycin. There have been no VRSA cases in Minnesota (MN). There were no VISA cases reported in 2021. Between 2008 and 2021, we had 19 VISA confirmed cases: 2008 (3), 2009 (3), 2010 (2), 2011 (5), 2013 (3), 2016 (2) and 2019 (1). Among all cases of VISA in MN, 11 (58%) were male and the median age was 64 years (range, 27 to 86). Of those cases with known history (18), 89% reported recent exposure to vancomycin.

• For up to date information see: Staphylococcus aureus

Invasive Staphylococcus aureus (SA) infections are classified into one of three categories: hospital-onset (HO-SA), healthcare-associated, community-onset (HACO-SA), and community-associated (CA-SA). SA must be isolated from a normally sterile body site greater than three days after the date of initial hospital admission for a case to be considered HO-SA. HACO-SA cases have at least one HA risk factor identified in the year prior to infection; examples of risk factors include residence in a long-term care facility, recent hospitalization(s), dialysis, presence of an indwelling central venous catheter, and surgery. CA-SA cases do not have any identifiable HA risk factors present in the year prior to infection. 

In 2005, as part of the EIP Active Bacterial Core surveillance (ABCs) population-based surveillance of invasive MRSA was initiated in Ramsey County; surveillance was expanded to include Hennepin County in 2008. The incidence rate was 14.8 per 100,000 in 2020 compared to 13.5 per 100,000 population in 2019. In 2020, MRSA was most frequently isolated from blood (84%, 224/268), and 14% (37/268) of the cases died in the hospital. HACO-MRSA cases comprised the majority (64%, 171/268) of invasive MRSA infections in 2020; CA-MRSA cases accounted for 23% (62/268) and 13% (35/268) cases were HO-MRSA. The median age for all cases was 55 years (range, <1 to 94); the median age was 57 years (range, 1 to 94), 59 (range, 12 to 88), and 41 (range, 2 to 89) for HO-, HACO-, and CA-MRSA cases, respectively. 

In August 2014, as part of the EIP Active Bacterial Core surveillance (ABCs) population-based surveillance of invasive MSSA was initiated in Hennepin and Ramsey Counties. The incidence rate was 30.6 per 100,000 in 2020 compared to 32.5 per 100,000 population in 2019. In 2020, MSSA was most frequently isolated from blood (83%, 459/554), and 13% (75/554) of the cases died in the hospital. HACO-MSSA cases comprised the majority (53%, 297/554) of invasive MSSA infections in 2020; CA-MSSA cases accounted for 35% (194/554) and 11% (63/554) cases were HO-MSSA. The median age for all cases was 59 years (range, <1 to 98); the median age was 60 (range, 3 to 95), 62 (range, 4 to 86), and 52 (range, 1 to 98) for HO-, HACO-, and CA- MSSA cases, respectively. 

Vancomycin-intermediate (VISA) and vancomycin-resistant S. aureus (VRSA) are reportable in Minnesota, as detected and defined according to Clinical and Laboratory Standards Institute approved standards and recommendations: a minimum inhibitory concentration (MIC)=4-8 μg/ml for VISA and MIC≥16 μg/ml for VRSA. Patients at risk for VISA and VRSA generally have underlying health conditions such as diabetes and end stage renal disease requiring dialysis, previous MRSA infections, recent hospitalizations, and recent exposure to vancomycin. There have been no VRSA cases in Minnesota (MN). There were no VISA cases reported in 2020. Between 2008 and 2020, the PHL has confirmed 19 VISA cases; 2008 (3), 2009 (3), 2010 (2), 2011 (5), 2013 (3), 2016 (2) and 2019 (1). Among all cases of VISA in Minnesota, 11 (58%) were male and the median age was 64 years (range, 27 to 86). Of those cases with known history (18), 89% reported recent exposure to vancomycin.

• For up to date information see: Staphylococcus aureus

Invasive Staphylococcus aureus (SA) infections are classified into one of three categories: hospital-onset (HOSA), healthcare-associated, community-onset (HACO-SA), and community-associated (CA-SA). SA must be isolated from a normally sterile body site greater than three days after the date of initial hospital admission for a case to be considered HO-SA. HACO-SA cases have at least one HA risk factor identified in the year prior to infection; examples of risk factors include residence in a long term care facility, recent hospitalization(s), dialysis, presence of an indwelling central venous catheter, and surgery. CA-SA cases do not have any identifiable HA risk factors present in the year prior to infection.

In 2005, as part of the EIP Active Bacterial Core surveillance (ABCs) population-based surveillance of invasive methicillin-resistant SA (MRSA) was initiated in Ramsey County; surveillance was expanded to include Hennepin County in 2008. The incidence rate was 13.5 per 100,000 in 2019 compared to 12.9 per 100,000 population in 2018. In 2019, MRSA was most frequently isolated from blood (76%, 187/245), and 9% (22/245) of the cases died in the hospital. HACO-MRSA cases comprised the majority (60%, 147/245) of invasive MRSA infections in 2019; CA-MRSA cases accounted for 27% (66/245) and 13% (32/245) cases were HO-MRSA. The median age for all cases was 57 years (range, <1 to 97); the median age was 57 (range, 1 to 90), 63 (range, 19 to 97), and 46 (range, 1 to 94) for HO-, HACO-, and CA-MRSA cases, respectively.

In August 2014, as part of the EIP ABCs population-based surveillance of invasive methicillin-sensitive SA (MSSA) was initiated in Hennepin and Ramsey Counties. The incidence rate was 32.5 per 100,000 in 2019 compared to 32.7 per 100,000 population in 2018. In 2019, MSSA was most frequently isolated from blood (74%, 438/590), and 8% (47/590) of the cases died in the hospital. HACO-MSSA cases comprised the majority (52%, 307/590) of invasive MSSA infections in 2019; CA-MSSA cases accounted for 38% (226/590) and 10% (57/590) cases were HO-MSSA. The median age for all cases was 59 years (range, <1 to 100); the median age was 51 (range, 1 to 87), 61 (range, 1 to 100), and 58 (range, 2 to 95) for HO-, HACO-, and CA- MSSA cases, respectively.

Vancomycin-intermediate (VISA) and vancomycin-resistant S. aureus (VRSA) are reportable in Minnesota, as detected and defined according to Clinical and Laboratory Standards Institute approved standards and recommendations: a minimum inhibitory concentration (MIC)=4-8 µg/ml for VISA and MIC ≥16 µg/ml for VRSA. Patients at risk for VISA and VRSA generally have underlying health conditions such as diabetes and end stage renal disease requiring dialysis, previous MRSA infections, recent hospitalizations, and recent exposure to vancomycin. There have been no VRSA cases in Minnesota. One case of VISA was confirmed in 2019. Between 2008 and 2019, we confirmed 19 VISA cases; 2008 (3), 2009 (3), 2010 (2), 2011 (5), 2013 (3), 2016 (2) and 2019 (1). Among these cases, 11 (58%) were male and the median age was 64 years (range, 27 to 86). Of those cases with known history (18), 89% reported recent exposure to vancomycin.

• For up to date information see: Staphylococcus aureus

Invasive Staphylococcus aureus (SA) infections are classified into one of three categories: hospital-onset (HO-SA), healthcare-associated, community-onset (HACO-SA), and community-associated (CA-SA). SA must be isolated from a normally sterile body site >3 days after the date of initial hospital admission for a case to be considered HO-SA. HACO-SA cases have at least one HA risk factor identified in the year prior to infection; examples of risk factors include residence in a long term care facility, recent hospitalization(s), dialysis, presence of an indwelling central venous catheter, and surgery. CA-SA cases do not have any identifiable HA risk factors present in the year prior to infection.

In 2005, as part of EIP, population based surveillance of invasive methicillin-resistant SA (MRSA) was initiated in Ramsey County; surveillance was expanded to include Hennepin County in 2008. The incidence rate was 12.9 per 100,000 in 2018 (Ramsey: 11.8/100,000 and Hennepin: 13.5/100,000) compared to 14.9 per 100,000 population in 2017. In 2018, MRSA was most frequently isolated from blood (83%, 183/221), and 10% (23/221) of the cases died in the hospital. HACOMRSA cases comprised the majority (62%, 137/221) of invasive MRSA infections in 2018; CA-MRSA cases accounted for 24% (53/221), and 14% (31/221) cases were HO-MRSA.

The median age for all cases was 58 years (range, <1 to 94); the median age was 53 (range, 8 to 91), 62 (range, <1 to 89), and 49 years (range, 2 to 94) for HO-, HACO-, and CA-MRSA cases, respectively.

In August 2014, invasive methicillin-sensitive SA (MSSA) was initiated in Hennepin and Ramsey Counties. The incidence rate was 32.7 per 100,000 in 2018 (Ramsey: 33.4/100,000 and Hennepin: 32.3/100,000) compared to 29.6 per 100,000 population in 2017. In 2018, MSSA was most frequently isolated from blood (79%, 439/556), and 10% (58/556) of the cases died in the hospital. HACO-MSSA cases comprised the majority (58%, 324/556) of invasive MSSA infections in 2018; CA-MSSA cases accounted for 31% (171/556), and 11% (61/556) cases were HO-MSSA. The median age for all cases was 60 years (range, <1 to 97); the median age was 61 (range, <1 to 94), 61 (range, 1 to 97), and 57 years (range, 2 to 95) for HO-, HACO-, and CA- MSSA cases, respectively.

Vancomycin-intermediate (VISA) and vancomycin-resistant S. aureus (VRSA) are reportable, as detected and defined according to Clinical and Laboratory Standards Institute approved standards and recommendations: a minimum inhibitory concentration (MIC)=4- 8 µg/ml for VISA and MIC≥16 µg/ ml for VRSA. Patients at risk for VISA and VRSA generally have underlying health conditions such as diabetes and end stage renal disease requiring dialysis, previous MRSA infection, recent hospitalization, and recent exposure to vancomycin. There have been no VRSA cases in Minnesota. Prior to 2008, the PHL had confirmed 1 VISA case. Between 2008 and 2016, the PHL confirmed 18 VISA cases: 2008 (3), 2009 (3), 2010 (2), 2011 (5), 2013 (3), and 2016 (2). Among all cases of VISA in Minnesota, 10 (53%) were male and the median age was 64 years (range, 27 to 86). Of those cases with known history (17), 89% reported recent exposure to vancomycin. No cases of VISA were confirmed in 2017 or 2018.

• For up to date information see: Staphylococcus aureus

• Archive of Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health
  Archive of past summaries (years prior to 2023 are available as PDFs).