Background/Introduction:
Methicillin-resistant _Staphylococcus aureus_ (MRSA) is one of the most common causes of hospital-acquired bacterial infections worldwide. Even though the percentage of MRSA is decreasing in european region, resistance levels remain high in some countries, including Italy, where it currently reaches 30%.

Methods:
Microorganisms isolated at Microbiology Unit of Ospedale Policlinico San Martino IRCCS, Genoa, from 1st January 2014 to 30th June 2022 were included. Blood was the only specimen considered. We excluded same patient cases within 30 days one from another and cases where the antimicrobial resistance (AMR) was not tested. Our surveillance includes the same pathogens monitored in the AMR surveillance by European Centre for Disease and prevention and Control (ECDC). In particular, the analysis also included AMR profile of _Pseudomonas aeruginosa_, _Acinetobacter spp_, _Streptococcus pneumoniae_, _Escherichia coli_, _Klebsiella pneumoniae_, _Enterococcus faecalis_ and _Enterococcus faecium_.

Results:
Average proportion of MRSA was 54.4% in 2014, 51.3% in 2015, 44.7% in 2016, 41.1% in 2017, 44.2 % in 2018, 43.2% in 2019, 40% in 2020, 36.6% in 2021 and 33.1% in first semester of 2022. The incidence of MRSA was 2.4/10000 patient-days in 2014, 3.1/10000 patient-days in 2015, 2.9/10000 patient-days in 2016, 2.8/10000 patient-days in 2017, 3.3/10000 patient-days in 2018, 2.8/10000 patient-days in 2019, 3.2/10000 patient-days in 2020, 3.2/10000 patient-days in 2021 and 2.9/10000 patient-days in first semester of 2022.

Conclusions:
Since the beginning of the surveillance (2014) the Incidence of MRSA remained stable (2.4-3.3/10000 patient-days). In comparison to the last ECDC AMR Report (2020), however, the proportion of MRSA significantly decreased, but remained above the European average. Further improvements in our infection-control practices are of paramount importance to limit the high mortality related to MRSA bloodstream infections.