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Updated: Apr 21, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Hospital-wide infection control practice and Meticillin-resistant Staphylococcus aureus (MRSA) in the intensive care
David S Thompson1, Rella Workman1
1Departments of Medicine and Microbiology, Medway Maritime Hospital, Gillingham, ME7 5NY, UK.
Objectives:
To estimate trends in infection/colonisation with meticillin-resistant Staphylococcus aureus (MRSA) in an intensive care unit (ICU).
Design:
Observational study of results of ICU admission and weekly screens for MRSA.
Setting And Participants:
All ICU admissions in 2001-2012.
Interventions:
ICU admissions were screened for MRSA throughout. In late 2006, screening was extended to the whole hospital and extra measures taken in ICU.
Main Outcome Measures:
Prevalence of MRSA in ICU admissions and number acquiring MRSA therein.
Results:
In all, 366 of 6565 admissions to ICU were MRSA positive, including 270 of 4466 coming from within the hospital in which prevalence increased with time prior to transfer to ICU. Prevalence in this group was 9.4% (8.2-10.6) in 2001-2006, decreasing to 3.4% (2.3-4.5) in 2007-2009 and 1.3% (0.6-2.0) in 2010-2012, p < 0.001, due to decreased prevalence in those spending >5 days on wards before ICU admission: 18.9% (15.6-22.2) in 2001-2006, 7.1% (4.0-10.2) in 2007-2009 and 1.6% (0.1-3.1) in 2010-2012, p < 0.001. In addition, 201 patients acquired MRSA within ICU, the relative risk being greater when known positives present: 4.34 (3.98-4.70), p < 0.001. Acquisition rate/1000 bed days decreased from 13.3 (11.2-15.4) in 2001-2006 to 3.6 (2.6-4.6) in 2007-2012, p < 0.0001. Of 41 ICU-acquired MRSA bacteraemias, 38 were in 2001-2006. The risk of bacteraemia in those acquiring MRSA decreased from 25% (18.1-31.9) in 2001-2006 to 6.1% (0-12.8) thereafter, p = 0.022.
Conclusions:
Following better hospital-wide infection control, fewer MRSA-positive patients were admitted to ICU with a parallel decrease in acquisition therein. Better practice there reduced the risk of bacteraemia.
Insights
Hospital-wide infection control measures significantly reduced meticillin-resistant Staphylococcus aureus (MRSA) admissions to intensive care units (ICUs). This led to a parallel decrease in MRSA acquisition within ICUs and a lower risk of bacteraemia.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Hospital Epidemiology
Background:
- Meticillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings, particularly in intensive care units (ICUs).
- Understanding trends in MRSA colonization and infection is crucial for effective infection control strategies.
Purpose of the Study:
- To estimate temporal trends in meticillin-resistant Staphylococcus aureus (MRSA) infection and colonization among patients admitted to an intensive care unit (ICU).
- To evaluate the impact of hospital-wide infection control interventions on MRSA prevalence and acquisition within the ICU.
Main Methods:
- An observational study was conducted analyzing data from ICU admissions between 2001 and 2012.
- Patients admitted to the ICU were screened for MRSA upon admission and weekly thereafter.
- Hospital-wide screening and enhanced infection control measures in the ICU were implemented in late 2006.
Main Results:
- The prevalence of MRSA in ICU admissions decreased significantly over the study period, particularly for patients transferred from hospital wards.
- MRSA acquisition within the ICU also decreased substantially, with a notable reduction in ICU-acquired MRSA bacteraemias after 2006.
- The risk of developing bacteraemia among patients acquiring MRSA in the ICU was significantly lower in the later period.
Conclusions:
- Implementation of enhanced hospital-wide infection control measures led to a reduction in MRSA-positive patients admitted to the ICU.
- These interventions were associated with a parallel decrease in MRSA acquisition rates within the ICU.
- Improved infection control practices in the ICU effectively reduced the risk of MRSA bacteraemia.
