Related Experiment Videos
Acquisition of methicillin-resistant Staphylococcus aureus in a large intensive care unit
Caroline Marshall1, Glenys Harrington, Rory Wolfe
1Department of Epidemiology & Preventive Medicine, Monash University, Prahran, Victoria, Australia.
Objectives:
To determine the prevalence of MRSA colonization on admission to the ICU and the incidence of MRSA colonization in the ICU.
Design:
Prospective cohort study.
Setting:
University hospital.
Participants:
Patients admitted to the ICU in 2000-2001.
Methods:
Patients were screened for MRSA with nose, throat, groin, and axilla swabs on admission and discharge. MRSA acquisition was defined as a negative admission screen and a positive discharge screen. Risk factors analyzed included previous wards/current unit, gender, age, and length of stay prior to and in the ICU. Univariate and multivariate analyses were performed using logistic regression.
Results:
Of screened patients, 6.8% were MRSA colonized on admission to the ICU. Some patients (11.4%) became newly colonized during their stay in the ICU. Factors that remained significant in the multivariate analysis of MRSA colonization on admission were previous admission to various wards and length of stay prior to ICU admission of more than 3 days. In the multivariate analysis of MRSA acquisition in the ICU, being a trauma patient and length of stay in the ICU greater than 2 days remained significant Thirty-six percent of patients had both admission and discharge swabs taken. This percentage increased in the presence of a supervisory nurse.
Conclusion:
Significant acquisition of MRSA occurs in the ICU of our hospital, with trauma patients at increased risk. Patients who had been on the cardiothoracic ward prior to the ICU had a lower risk of MRSA colonization on admission. Presence of a supervisory nurse improved compliance with screening
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) colonization is common on ICU admission and acquisition occurs during ICU stays. Trauma patients face higher MRSA acquisition risk in the ICU.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings.
- Understanding MRSA colonization and acquisition is crucial for infection control in intensive care units (ICUs).
Purpose of the Study:
- To determine the prevalence of MRSA colonization upon ICU admission.
- To assess the incidence of new MRSA colonization acquired during ICU stays.
- To identify risk factors associated with MRSA colonization and acquisition in the ICU.
Main Methods:
- Prospective cohort study conducted at a university hospital.
- Screening for MRSA using multiple swabs on ICU admission and discharge.
- Logistic regression analysis to identify significant risk factors for MRSA colonization and acquisition.
Main Results:
- 6.8% of patients were colonized with MRSA on ICU admission.
- 11.4% of patients acquired new MRSA colonization during their ICU stay.
- Previous ward admission and prolonged pre-ICU stay were associated with admission MRSA colonization. Trauma patients and longer ICU stays increased acquisition risk.
Conclusions:
- Significant MRSA acquisition occurs within the ICU.
- Trauma patients are at a higher risk for MRSA acquisition in the ICU.
- Supervisory nurses improved compliance with MRSA screening protocols.