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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Risk factors affecting nasal colonization of methicillin-resistant Staphylococcus aureus when admitted in intensive
Qiang Li1, Taifeng Zhuang2, Ying Lin1
1Intensive Care Unit, Peking University Third Hospital, Beijing 100191, China.
Background:
Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is a risk factor for subsequent invasive MRSA infection, particularly in patients admitted for critical care. The purpose of this study was to investigate the risk factors affecting nasal colonization of MRSA in patients admitted to intensive care units (ICU).
Methods:
Between August 1, 2011 and June 30, 2012, we screened for MRSA nasal colonization in 350 patients by Real-time PCR within 24 hours of admission by means of swab samples taken from the anterior nares. According to the results of PCR, the patients were divided into 2 groups: the positive group with nasal MRSA colonization and the negative group without nasal MRSA colonization. The 31 (8.86%) patients were MRSA positive. The risk factors evaluated included thirteen variables, which were analyzed by t test for continuous variables and χ(2) test for discrete variables. The variables with significance (P < 0.05) were analyzed with stepwise Logistic regression.
Results:
There were differences (P < 0.05) in four variables between two groups. The duration of stay in hospital prior to ICU admission in the positive group was (35.7 ± 16.1) days, vs. (4.5 ± 3.1) days in the negative group. The average blood albumin level was (28.4 ± 2.9) g/L in the positive group, vs. (30.5 ± 4.3) g/L in the negative group. Of 31 patients in the positive group, seven had been treated with antibiotics longer than seven days vs. 34 of 319 patients in the negative group. In the positive group, four of 31 patients received treatment with more than two classes of antibiotics prior to admission in ICU, contrasted to 13 of 319 patients in the negative group. Furthermore, stepwise Logistic regression analysis for these four variables indicates that the duration of stay in hospital prior to ICU admission may be an independent risk factor.
Conclusions:
MRSA colonization in ICU admission may be related to many factors. The duration of stay in hospital prior to ICU admission is an independent risk factor.
Insights
Prolonged prior hospital stays increase methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization risk in intensive care unit (ICU) admissions. This finding highlights the importance of considering previous hospital duration when assessing ICU patients for MRSA.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Clinical Microbiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) colonization is a known precursor to invasive infection, especially in critical care settings.
- Identifying risk factors for MRSA nasal colonization in intensive care unit (ICU) patients is crucial for infection control.
Purpose of the Study:
- To investigate the risk factors associated with methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization in patients admitted to intensive care units (ICUs).
Main Methods:
- A prospective study screened 350 ICU admissions for MRSA nasal colonization using Real-time PCR within 24 hours of admission.
- Patients were categorized into MRSA-positive (n=31) and MRSA-negative groups.
- Risk factors were analyzed using t-tests, chi-squared tests, and stepwise Logistic regression.
Main Results:
- The MRSA-positive group had a significantly longer prior hospital stay (35.7 days vs. 4.5 days) compared to the MRSA-negative group.
- Lower average blood albumin levels and longer durations of antibiotic treatment (both >7 days and >2 classes) were also associated with MRSA colonization.
- Logistic regression identified prior hospital stay duration as an independent risk factor for MRSA nasal colonization.
Conclusions:
- MRSA colonization upon ICU admission is multifactorial.
- Extended duration of hospital stay prior to ICU admission is a significant independent risk factor for MRSA nasal colonization.
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