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[Meticillin-resistant Staphylococcus aureus: incidence, risk factors and interest of systematic screening for
1Laboratoire de Bactériologie et d'Hygiène Hospitalière, CHU de Nantes, Boulevard J.-Monod-Saint-Herblain 1, Place A.-Ricordeau, 44093 Nantes cedex 01, France. didier.lepelletier@chu-nantes.fr
Objective:
To summarize recent international and national epidemiological data of methicillin-resistant Staphylococcus aureus (MRSA) colonization in ICU.
Study Design:
Review articles using Medline, CDC (Atlanta, GA, USA) and IVS (St Maurice, France) databases (1994-2004): critical assessment of literature and data of MRSA colonization epidemiology in ICU.
Results:
MRSA colonization varied from 3 to 14% on ICU admission. Five to twelve percent of patient acquired MRSA colonization during hospitalization. This reservoir is often unknown as clinical sample identifies only a part of MRSA colonization. The probability to develop an infection caused by MRSA in colonized patients is about 30%. Acquisition of MRSA in ICU patients is strongly and independently influenced by colonization pressure.
Conclusion:
Systematic screening for colonization on ICU admission and during hospitalization is essential for many authors to control the spread of MRSA. Other policies such as implementation of isolation precaution and antibiotic use also contribute to decrease the MRSA incidence rate observed for several years in French ICU.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) colonization is common in intensive care units (ICUs), with significant patient acquisition during hospitalization. Screening and infection control measures are crucial to manage MRSA spread.
Area of Science:
- Epidemiology
- Infectious Diseases
- Critical Care Medicine
Context:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in intensive care units (ICUs).
- Understanding MRSA colonization patterns is vital for effective infection control.
- Previous epidemiological data on MRSA colonization in ICUs requires synthesis.
Purpose:
- To summarize current international and national epidemiological data on MRSA colonization in the ICU setting.
- To assess the prevalence and incidence of MRSA colonization among ICU patients.
- To identify factors influencing MRSA acquisition in ICUs.
Summary:
- MRSA colonization on ICU admission ranges from 3-14%, with 5-12% of patients acquiring it during hospitalization.
- Clinical samples often underestimate the true extent of MRSA colonization.
- Colonized patients have a 30% probability of developing MRSA infection, with colonization pressure being a key acquisition factor.
Impact:
- Highlights the necessity of systematic MRSA screening upon ICU admission and during hospitalization.
- Emphasizes the role of isolation precautions and antibiotic stewardship in reducing MRSA incidence.
- Provides evidence for implementing targeted interventions to control MRSA in critical care settings.
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