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Outbreak of multiply resistant Staphylococcus aureus in a pediatric intensive care unit after consolidation with a
B S Ribner1, M N Landry, K Kidd
1Department of Medicine, Duke University Medical Center, Asheville, NC 28805.
Insights
Combining pediatric and adult intensive care units led to a significant increase in pediatric patients acquiring methicillin-resistant Staphylococcus aureus (MRSA). Separating the units successfully reduced MRSA acquisition in pediatric patients.
Area of Science:
- Infectious Disease Epidemiology
- Critical Care Medicine
- Pediatric Health
Background:
- Adult surgical intensive care units (SICUs) can harbor multidrug-resistant organisms.
- Co-location of pediatric patients with adult populations in ICUs is a growing concern for infection control.
Purpose of the Study:
- To investigate the impact of co-locating pediatric patients in an adult SICU on the acquisition of methicillin-resistant Staphylococcus aureus (MRSA).
Main Methods:
- A retrospective analysis of MRSA acquisition rates before, during, and after the co-location period.
- Comparison of MRSA rates between pediatric and adult patients during the combined occupancy.
- Analysis of patient factors associated with MRSA acquisition in the pediatric group.
Main Results:
- MRSA occurrence in pediatric patients increased significantly from zero to seven cases during the 95-day co-location period (p < 0.001).
- The rate of MRSA acquisition among adult SICU patients remained unchanged.
- Pediatric patients who acquired MRSA experienced longer hospital stays and more surgical/invasive procedures.
Conclusions:
- Co-locating pediatric patients in adult SICUs can lead to increased MRSA acquisition in the pediatric population.
- Segregating pediatric patients back into their own unit effectively reduced MRSA acquisition rates.
- Implementing strict infection control measures is crucial when pediatric and adult patients share intensive care environments.
Abstract:
Patients in a pediatric intensive care unit were placed with patients in an adult surgical intensive care unit (SICU) in a large, 12-bed room previously occupied exclusively by the adult patients. The occurrence of multiply resistant Staphylococcus aureus (MRSA) in pediatric patients increased from zero cases during the preceding 12 months to seven cases (p less than 0.001) for the 95 days that the units were combined. The rate of acquisition of MRSA by the patients in the SICU remained unchanged. Pediatric patients who acquired MRSA had longer lengths of stay (p less than 0.001) and underwent more surgical (p less than 0.01) and invasive procedures than did pediatric patients who did not acquire MRSA. Removal of the pediatric patients to their own unit returned their rate of MRSA acquisition to the previous low level.