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Updated: May 27, 2026
Biosensor for Detection of Antibiotic Resistant Staphylococcus Bacteria
Published on: May 8, 2013
Screening and control of methicillin-resistant Staphylococcus aureus in 186 intensive care units: different
Anke Kohlenberg1, Frank Schwab, Michael Behnke
1Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Goldenfelsstrasse 19-21, 50935 Cologne, Germany. akohlenberg@gmx.de
Introduction:
Controversy exists about the benefit of screening for prevention of methicillin-resistant Staphylococcus aureus (MRSA) in intensive care units (ICUs) and recent studies have shown conflicting results. The aim of this observational study was to describe and evaluate the association between MRSA incidence densities (IDs) and screening and control measures in ICUs participating in the German Nosocomial Infection Surveillance System.
Methods:
The surveillance module for multidrug-resistant bacteria collects data on MRSA cases in ICUs with the aim to provide a national reference and a tool for evaluation of infection control management. The median IDs of MRSA cases per 1000 patient-days (pd) with the interquartile range (IQR) were calculated from the pooled data of 186 ICUs and correlated with parameters derived from a detailed questionnaire regarding ICU structure, microbiological diagnostics and MRSA screening and control measures. The association between questionnaire results and MRSA cases was evaluated by generalized linear regression models.
Results:
One hundred eighty-six ICUs submitted data on MRSA cases for 2007 and 2008 and completed the questionnaire. During the period of analysis, 4935 MRSA cases occurred in these ICUs; of these, 3928 (79.6%) were imported and 1007 MRSA cases (20.4%) were ICU-acquired. Median MRSA IDs were 3.23 (IQR 1.24-5.73), 2.24 (IQR 0.63-4.30) and 0.64 (IQR 0.17-1.39) per 1000 pd for all cases, imported and ICU-acquired MRSA cases, respectively. MRSA IDs as well as implemented MRSA screening and control measures varied widely between ICUs. ICUs performing universal admission screening had significantly higher MRSA IDs than ICUs performing targeted or no screening. Separate regression models for ICUs with different screening strategies included the incidence of imported MRSA cases, the type of ICU, and the length of stay in independent association with the number of ICU-acquired MRSA cases.
Conclusions:
The analysis shows that MRSA IDs and structural parameters differ considerably between ICUs. In response, ICUs have combined screening and control measures in many ways to achieve various individual solutions. The incidence of imported MRSA cases might be helpful for consideration in the planning of MRSA control programmes.
Insights
Universal screening for methicillin-resistant Staphylococcus aureus (MRSA) in intensive care units (ICUs) was associated with higher MRSA incidence densities. Imported MRSA cases and ICU type influenced ICU-acquired MRSA cases.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Public Health
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) prevention in intensive care units (ICUs) remains controversial.
- Conflicting study results highlight the need for further investigation into MRSA screening effectiveness.
Purpose of the Study:
- To evaluate the association between MRSA incidence densities (IDs) and screening/control measures in German ICUs.
- To analyze factors influencing MRSA acquisition within ICUs.
Main Methods:
- Observational study using data from the German Nosocomial Infection Surveillance System (n=186 ICUs).
- Calculation of MRSA IDs per 1000 patient-days (pd).
- Correlation of MRSA IDs with ICU structure, diagnostics, and screening strategies using generalized linear regression models.
Main Results:
- A total of 4935 MRSA cases were reported; 79.6% were imported and 20.4% were ICU-acquired.
- Median MRSA IDs were 3.23/1000 pd (all), 2.24/1000 pd (imported), and 0.64/1000 pd (ICU-acquired).
- ICUs with universal admission screening showed significantly higher MRSA IDs compared to targeted or no screening.
Conclusions:
- Significant variation exists in MRSA IDs and control measures across ICUs.
- Imported MRSA cases and ICU type are independent predictors of ICU-acquired MRSA.
- Consideration of imported MRSA case incidence is recommended for planning MRSA control programs.
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