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Methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci co-colonization

Jon P Furuno1, Eli N Perencevich, Judith A Johnson

  • 1Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. jfuruno@epi.umaryland.edu

Emerging Infectious Diseases
|December 2, 2005
PubMed

Insights

A study found that 2.7% of ICU patients were co-colonized with vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA). Risk factors included older age, medical ICU admission, male sex, and prior antimicrobial use.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Microbiology

Background:

  • Co-colonization with multidrug-resistant organisms poses a significant threat in healthcare settings.
  • Vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) are common healthcare-associated pathogens.
  • Understanding co-colonization patterns is crucial for infection control.

Purpose of the Study:

  • To determine the prevalence of co-colonization with VRE and MRSA upon ICU admission.
  • To identify independent risk factors associated with VRE/MRSA co-colonization.
  • To assess the clinical implications and detection rates of co-colonization.

Main Methods:

  • Prospective cohort study of 2,440 patients admitted to medical and surgical ICUs.
  • Concurrent perirectal (VRE) and anterior nares (MRSA) surveillance cultures were collected.
  • Multivariable logistic regression analysis was used to identify risk factors.

Main Results:

  • The prevalence of VRE/MRSA co-colonization was 2.7% (65/2,440 patients).
  • Independent risk factors included older age, medical ICU admission, male sex, and prior antimicrobial exposure.
  • Clinical cultures alone would not have identified any co-colonized patients.

Conclusions:

  • VRE/MRSA co-colonization is prevalent upon ICU admission in tertiary-care facilities.
  • Targeted surveillance may be necessary to identify co-colonized patients.
  • Early identification of co-colonization is essential for effective infection prevention strategies.

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