Macau, recognized as a global tourism hub and the world’s most densely populated region, provides a unique environment conducive to methicillin-resistant Staphylococcus aureus (MRSA) transmission in healthcare and community settings, posing a significant public health concern both locally and globally. The epidemiology and molecular characteristics of MRSA in the distinct city of Macau remain largely unelucidated. This five-year longitudinal study (2017–2022) examined the local prevalence and molecular typing of MRSA in Macau, with future MRSA type distribution predicted through ARIMA modeling. We subsequently analyzed the epidemiological characteristics of MRSA, including specimen source, clinical department, collection year, season, patient age, sex, and the annual number of tourists. Comprehensive antibiotic resistance profiles of the strains were also assessed. Of 504 clinically isolated S. aureus strains, 183 (36.3%) were identified as MRSA by the cefoxitin disk diffusion method and validated through multi-locus sequence typing (MLST). The MRSA detection rate showed an upward trend, increasing from 30.1% in 2017 to 45.7% in 2022. SCCmec type IV was predominant (28.9%), followed by types II (25.4%), III (22.1%), and V (22.1%). The primary sources of MRSA isolates were sputum (39.2%) and secretions (25.6%). Older age emerged as a risk factor for MRSA infection, whereas no significant associations were found with seasonal variations, gender, or the annual number of tourists. Despite displaying universal resistance to cefoxitin, oxacillin, and benzylpenicillin, MRSA isolates in Macau remained fully sensitive to vancomycin, tigecycline, quinupristin, nitrofurantoin, and linezolid. Continuous surveillance and analysis of MRSA distribution in Macau could provide invaluable insights for the effective management of MRSA prevention and control measures within healthcare settings.

As global ageing, Gerontological Nursing (GN) course is important in nursing education. The purpose of this paper is to demonstrate the use of aged simulation and virtual reality (VR) in GN education and evaluate the students’ perceptions and feedbacks of the aged simulation and VR learning activity. Based on The Learning Pyramid, the “Practice by doing” will get about 75% average learning retention rates among learners. The aged simulation and VR approaches were adopted in GN course in Macao. Three stages of implementation were planned and applied including preparation, application, and debriefing and feedback by using aged simulation set and VR equipment as study tools. The software was installed into VR equipment such as visual problems among older people. The duration of wearing aged simulation was about two hours for each time. The setting of the simulation and VR learning was held at nursing lab. Nursing students have the positive feelings and experiences towards aged simulation and VR learning activity, they suggested this aged simulation and VR learning activity should be included in Gerontological Nursing course.