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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
What we can do? The risk factors for multi-drug resistant infection in pediatric intensive care unit (PICU): a
1Nursing Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
Background:
The risk factors for multi-drug resistant infection (MDRI) in the pediatric intensive care unit (PICU) remain unclear. It's necessary to evaluate the epidemiological characteristics and risk factors for MDRI in PICU, to provide insights into the prophylaxis of MDRI clinically.
Methods:
Clinical data of 79 PICU children with MDRI were identified, and 80 children in PICU without MDRI in the same period were selected as control group. The related children's characteristics, clinical care, microbiologic data, treatments provided, and outcomes of the patients with were reviewed and collected. Univariate and multivariate logistic regression analyses were performed to identify the potential risks of MDRI in PICU.
Results:
Of the diagnosed 79 cases of MDRI, there were28 cases of CR-AB, 24 cases of MRSA, 22 cases of PDR-PA,3 cases of VRE and 2 cases of CRE respectively. Univariate analyses indicated that the length of PICU stay, the duration of mechanical ventilation > 5 days, parenteral nutrition, coma, urinary catheter indwelling, invasive operation, 2 or more antibiotics use were associated with MDRIs (all p < 0.05); The logistic multiple regression analyses indicated that coma, parenteral nutrition, 2 or more antibiotics use and the duration of mechanical ventilation > 5 days were independent risk factors associated with MDRI (all p < 0.05).
Conclusions:
This present study has identified several potentially modifiable risk factors for MDRI in PICU, it's conducive to take appropriate measures targeting risk factors of MDRI for health care providers to reduce MDRI.
Insights
Multi-drug resistant infections (MDRI) in the pediatric intensive care unit (PICU) are associated with prolonged mechanical ventilation, coma, parenteral nutrition, and multiple antibiotic use. Identifying these risk factors can help reduce MDRI in critically ill children.
Area of Science:
- Pediatric Intensive Care
- Infectious Diseases
- Epidemiology
Background:
- Multi-drug resistant infections (MDRI) pose a significant threat in pediatric intensive care units (PICUs).
- Risk factors and epidemiological characteristics of MDRI in PICU settings require further elucidation for effective clinical prophylaxis.
- Understanding MDRI is crucial for improving patient outcomes in critical care.
Purpose of the Study:
- To evaluate the epidemiological characteristics of MDRI in PICU patients.
- To identify independent risk factors associated with MDRI in a pediatric intensive care setting.
- To inform clinical strategies for the prevention and management of MDRI.
Main Methods:
- A case-control study involving 79 PICU children with MDRI and 80 controls without MDRI.
- Collection of clinical data, including patient characteristics, care, microbiology, treatments, and outcomes.
- Univariate and multivariate logistic regression analyses were employed to determine risk factors.
Main Results:
- Common MDRIs included carbapenem-resistant Acinetobacter baumannii (CR-AB), methicillin-resistant Staphylococcus aureus (MRSA), and Pseudomonas aeruginosa (PDR-PA).
- Univariate analysis identified prolonged PICU stay, mechanical ventilation >5 days, parenteral nutrition, coma, urinary catheter, invasive procedures, and multiple antibiotic use as associated factors.
- Multivariate analysis revealed coma, parenteral nutrition, multiple antibiotic use, and mechanical ventilation >5 days as independent risk factors for MDRI.
Conclusions:
- Several potentially modifiable risk factors for MDRI in the PICU have been identified.
- Targeting identified risk factors like coma, parenteral nutrition, antibiotic use, and ventilation duration can aid in reducing MDRI.
- These findings support the development of targeted interventions for healthcare providers to mitigate MDRI risks in PICU.
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