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[Prevention and treatment of MRSA infection in emergency surgical ward]
1Department of Critical Care and Emergency Medicine, Yokohama City University, School of Medicine, Japan.
Abstract:
During two years of 1990 and 1991, methicillin-resistant Staphylococcus aureus (MRSA) strains were isolated from 121 patients who were admitted to our emergency ward with infection rate of 7% (121/1843). The end results were miserable and the mortality rate was 28%. The infection rate was significantly higher than that of general surgical ward (2%). Specimens of respiratory tract such as coughed-up sputum and tracheal secretion showed high rate of MRSA isolation, especially in patients who underwent tracheal intubation or tracheostomy. All of these MRSA strains were strongly resistant to antibiotics and were typed as coagulase II. MRSA strains were isolated from nostril of medical staff and in-ward patients while admission with rate of 9% and 3%, respectively. Meanwhile, the MRSA strains were also isolated from the materials surrounding the infected patients such as bed, door, gowns and hands of in-charge nurses. To prevent inter-patient transmission, the infected patients were placed in isolation room and cared with isolation technique. Handwashing with benzalkonium chloride-alcohol is strongly recommended. Intravenous injection of IPM and CEZ or VCM is indicated. Local use of MINO was reported to be useful. In conclusion, MRSA infection often occurs in the immunodepressive patients and is hard to cure.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) caused a 7% infection rate and 28% mortality in emergency ward patients. This study highlights MRSA
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Context:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings.
- The study investigated MRSA prevalence and outcomes in an emergency ward between 1990-1991.
- High infection rates were observed compared to general surgical wards.
Purpose:
- To determine the incidence and characteristics of MRSA infections in an emergency ward.
- To identify sources of MRSA transmission within the hospital environment.
- To evaluate the mortality associated with MRSA in this patient population.
Summary:
- MRSA was isolated from 121 emergency ward patients (7% infection rate), with a 28% mortality rate.
- Respiratory tract specimens, particularly from intubated patients, showed high MRSA isolation.
- MRSA strains were identified on medical staff, patients, and environmental surfaces, indicating widespread contamination.
Impact:
- The findings underscore the critical need for stringent infection control measures against MRSA.
- Effective prevention strategies include isolation techniques, hand hygiene, and appropriate antibiotic therapy.
- MRSA infections are particularly challenging in immunocompromised patients, necessitating targeted interventions.