scholarly journals Methicillin-resistant Staphylococcus aureus in the ICU: risk factors and a predictive model to detect it at ICU admission

Critical Care ◽  
2015 ◽  
Vol 19 (Suppl 1) ◽  
pp. P101
Author(s):  
F Callejo-Torre ◽  
JM Eiros ◽  
S Ossa-Echeverri ◽  
P Olaechea ◽  
M Palomar ◽  
...  
Author(s):  
Beladenta Amalia ◽  
Yulia Rosa Saharman

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the Multidrug-resistant organisms (MDRO) which has been quite an endemic in many healthcare facilities, especially in the Intensive Care Unite (ICU) of hospitals. History of patients’ hospitalization before ICU admission has been considered to be one of the risk factors for MRSA colonization in patients. Problems arised after knowing that ICU patients with MRSA colonization are at high risk of MRSA infection. Therefore, we require data of MRSA colonization associated history of patients’ hospitalization before ICU admission in hopes that the incidence of MRSA colonization in Indonesia hospitals can be reduced. This is an analytical cross sectional study using secondary data results from microbiological examination of swabs (nose, underarms, and rectum) and medical records of 109 patients from the Central ICU RSCM on January 2011 until August 2011. Sample selection was conducted by consecutive sampling. Microbiological examination results which were used in this study were the results of MRSA resistance test both in patients who had history of hospitalization before ICU admission and those who did not. Data was analyzed using Chi-squared test. The result of comparing data between the proportion of patients with positive MRSA colonization and had history of hospitalization to the proportion of patients with positive MRSA colonization but did not have history of hospitalization was PR (prevalence ratio)=1,206 with significance value p=0,307 and CI95% -3,087; 5,499. This suggests that history of patients’ hospitalization before ICU admission was not the only factor to affect MRSA colonization. Antibiotic administrations and prior contact with MRSA carrier in the community might be other risk factors which may obscure this result. It indicates that hospitals should conduct routine MRSA colonization screening to all patients, regardless of their history of hospitalization, as a standard precaution for infection control.


2012 ◽  
Vol 45 (2) ◽  
pp. 189-193 ◽  
Author(s):  
Karinne Spirandelli Carvalho Naves ◽  
Natália Vaz da Trindade ◽  
Paulo Pinto Gontijo Filho

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) is spread out in hospitals across different regions of the world and is regarded as the major agent of nosocomial infections, causing infections such as skin and soft tissue pneumonia and sepsis. The aim of this study was to identify risk factors for methicillin-resistance in Staphylococcus aureus bloodstream infection (BSI) and the predictive factors for death. METHODS: A retrospective cohort of fifty-one patients presenting bacteraemia due to S. aureus between September 2006 and September 2008 was analysed. Staphylococcu aureus samples were obtained from blood cultures performed by clinical hospital microbiology laboratory from the Uberlândia Federal University. Methicillinresistance was determined by growth on oxacillin screen agar and antimicrobial susceptibility by means of the disk diffusion method. RESULTS: We found similar numbers of MRSA (56.8%) and methicillin-susceptible Staphylococcus aureus (MSSA) (43.2%) infections, and the overall hospital mortality ratio was 47%, predominantly in MRSA group (70.8% vs. 29.2%) (p=0.05). Age (p=0.02) was significantly higher in MRSA patients as also was the use of central venous catheter (p=0.02). The use of two or more antimicrobial agents (p=0.03) and the length of hospital stay prior to bacteraemia superior to seven days (p=0.006) were associated with mortality. High odds ratio value was observed in cardiopathy as comorbidity. CONCLUSIONS: Despite several risk factors associated with MRSA and MSSA infection, the use of two or more antimicrobial agents was the unique independent variable associated with mortality.


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