Incidence of and risk factors for community-associated methicillin- resistant Staphylococcus aureus acquired infection or colonization in intensive-care-unit patients
Journal
Journal of Clinical Microbiology
Journal Volume
48
Journal Issue
12
Pages
4439-4444
Date Issued
2010
Author(s)
Abstract
The incidence of and risk factors for acquiring community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) among patients staying in intensive care units (ICUs) remain unclear. We enrolled patients staying in two ICUs at the Far Eastern Memorial Hospital during the period of 1 September 2008 to 30 September 2009 to clarify this issue. Surveillance cultures for MRSA were taken from nostril, sputum or throat, axillae, and the inguinal area in all enrolled patients upon admission to the ICU, every 3 days thereafter, and on the day of discharge from the ICU. For each MRSA isolate, we performed multilocus sequence typing, identified the type of staphylococcal cassette chromosome mec, detected the presence of the Panton-Valentine leukocidin gene, and conducted drug susceptibility tests. Among the 1,906 patients who were screened, 203 patients were carriers of MRSA before their admission to the ICU; 81 patients acquired MRSA during their stay in the ICU, including 31 who acquired CA-MRSA. The incidence rates of newly acquired MRSA and CA-MRSA during the ICU stay were 7.9 and 3.0 per 1,000 patient-days, respectively. Prior usage of antipseudomonal penicillins and antifungals and the presence of a nasogastric tube were found to be independent risk factors for acquiring CA-MRSA during the ICU stay when data for CA-MRSA carriers and patients without carriage of MRSA were compared (P = 0.0035, 0.0330, and 0.0262, respectively). Prior usage of carbapenems was found to be a protective factor against acquiring CA-MRSA when data for patients with CA-MRSA and those with health care-associated MRSA acquired during ICU stay were compared (P = 0.0240). Copyright ? 2010, American Society for Microbiology. All Rights Reserved.
SDGs
Other Subjects
antifungal agent; carbapenem derivative; Panton Valentine leukocidin; penicillin derivative; adult; aged; antibiotic sensitivity; article; axilla; bacterial chromosome; bacterial colonization; bacterium culture; bacterium isolate; communicable disease; controlled study; critically ill patient; female; hospital admission; hospital discharge; human; inguinal region; intensive care unit; major clinical study; male; methicillin resistant Staphylococcus aureus; methicillin resistant Staphylococcus aureus infection; morbidity; multilocus sequence typing; nasogastric tube; nose; priority journal; risk factor; sputum culture; throat culture; Abdomen; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Axilla; Bacterial Toxins; Carrier State; Community-Acquired Infections; Cross Infection; Exotoxins; Female; Humans; Incidence; Intensive Care Units; Leukocidins; Male; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Middle Aged; Multilocus Sequence Typing; Nose; Pharynx; Risk Factors; Sputum; Staphylococcal Infections; Young Adult; methicillin resistant Staphylococcus aureus
Type
journal article