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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA

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Risk Factors of Methicillin-Resistant Staphylococcus aureus Infection and Correlation With Nasal Colonization Based

Kuo-Chin Kao1, Chun-Bing Chen, Han-Chung Hu

  • 1Department of Thoracic Medicine and Respiratory Therapy, Chang Gung University College of Medicine, Linkou (K-CK, H-CH, C-CH); Department of Dermatology, Chang Gung University College of Medicine, Keelung (C-BC); Department of Pediatrics, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan (H-CC, Y-CH).

Medicine
|July 17, 2015
PubMed

Insights

Nasal colonization by Methicillin-resistant Staphylococcus aureus (MRSA) significantly increases the risk of subsequent MRSA infections in medical intensive care unit (ICU) patients. Tracheostomy history was found to reduce this risk, with most isolates being healthcare-associated strains.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen in healthcare settings, particularly in intensive care units (ICUs).
  • Nasal colonization is a known risk factor for subsequent MRSA infections.

Purpose of the Study:

  • To investigate the association between MRSA nasal colonization and the development of subsequent MRSA infections in medical ICU patients.
  • To identify independent predictors of MRSA infection in this patient population.

Main Methods:

  • Prospective cohort observational study of 1266 medical ICU patients over 18 months.
  • Nasal specimens collected within 3 days and 1 week of ICU admission for MRSA detection.
  • Molecular genotyping used to compare nasal and clinical MRSA isolates.

Main Results:

  • MRSA nasal colonization was independently associated with a 2.50-fold increased risk of subsequent MRSA infection (P < 0.001).
  • Patients with nasal colonization had a 39.1% infection rate compared to 14.7% in non-colonized patients.
  • History of tracheostomy was a protective factor, reducing the risk of MRSA infection (RR: 0.38, P = 0.010).

Conclusions:

  • MRSA nasal colonization is a strong predictor of subsequent MRSA infections in medical ICU patients.
  • Healthcare-associated MRSA clones were prevalent, with significant genetic correlation between nasal and clinical isolates.
  • Tracheostomy history may mitigate MRSA infection risk in ICU settings.

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