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Occurrence of methicillin-resistant Staphylococcus aureus infections in German intensive care units
P Gastmeier1, D Sohr, C Geffers
1Division of Hospital Epidemiology and Infection Control, Institute of Medical Microbiology and Hospital Epidemiology, Hanover Medical School, Germany. Gastmeier.Petra@mh-hannover.de
Background:
This study aims to describe the occurrence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infections and the relation between endemic and epidemic nosocomial MRSA infections in intensive care units (ICUs) in Germany.
Methods:
The ICU component within the German national nosocomial infections surveillance system (KISS) was established in January 1997. The number of participating ICUs increased from 25 in 1997 to 178 (June 2000). In every case of nosocomial infection (NI), the pathogens identified were referred to the surveillance system. To identify clusters and outbreaks and distinguish them from mere single events, the following simple definitions were applied: a "cluster" was two nosocomial MRSA infections within 3 months; an "outbreak" was three or more nosocomial MRSA infections within 3 months; all other MRSA infections were classed as "single events."
Results:
A total of 10,261 NIs were identified during the observation period in the 139 ICUs which had been participating for at least 6 months. Among the 1,535 nosocomial S. aureus infections, 219 MRSA infections were identified (14.3%). Only 51 (36.7%) of the 139 KISS ICUs identified nosocomial MRSA infections. In 12 ICUs (8.6%) however, more than 50% of all nosocomial S. aureus infections were caused by MRSA. The mean incidence density was 0.31 nosocomial MRSA infections/1,000 patient days (range 0-3.6). Outbreaks were registered in 13 ICUs, clusters in 12 further ICUs and only single events in the remaining 26. 64.0% of all MRSA infections were registered during outbreaks and 12.8% in cluster situations. Thus, only 23.2% of MRSA infections were single events.
Conclusion:
These definitions of clusters and outbreaks can only provide an estimate of the real number of cases. However, through the targeted identification of ICUs with endemic and epidemic MRSA problems and subsequent strict measures to prevent the spread of MRSA within these ICUs, it may be possible to retain, or even reduce, the present level of MRSA infections in Germany.
Insights
Nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infections are a significant concern in German intensive care units (ICUs). This study found that outbreaks and clusters accounted for the majority of MRSA cases, highlighting the need for targeted prevention strategies.
Area of Science:
- Infectious Diseases
- Epidemiology
- Critical Care Medicine
Background:
- Nosocomial infections, particularly methicillin-resistant Staphylococcus aureus (MRSA), pose a significant challenge in intensive care units (ICUs).
- Understanding the patterns of MRSA occurrence, including endemic and epidemic situations, is crucial for effective control.
Purpose of the Study:
- To describe the incidence of nosocomial MRSA infections in German ICUs.
- To analyze the relationship between endemic and epidemic MRSA occurrences within these critical care settings.
Main Methods:
- Utilized data from the German national nosocomial infections surveillance system (KISS) ICU component from January 1997 to June 2000.
- Defined 'clusters' as two MRSA infections within 3 months and 'outbreaks' as three or more within 3 months to differentiate from single events.
- Collected pathogen data from participating ICUs to identify and categorize nosocomial infections.
Main Results:
- Out of 10,261 nosocomial infections, 219 (14.3%) were MRSA, identified in 51 (36.7%) of 139 ICUs.
- 13 ICUs experienced outbreaks, 12 had clusters, and 26 reported single events.
- Outbreaks and clusters accounted for 64.0% and 12.8% of MRSA infections, respectively, with only 23.2% classified as single events.
Conclusions:
- The definitions used provide an estimate of MRSA cases, differentiating between single events, clusters, and outbreaks.
- Targeted identification of ICUs with endemic or epidemic MRSA issues is essential.
- Implementing strict preventive measures in affected ICUs can help maintain or reduce MRSA infection levels in Germany.