Risk Factors for Methicillin-Resistant Staphylococcus aureus Carriers in the Intensive Care Unit: A Single-Center,...

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Epidemiology

Background:

• Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen in intensive care units (ICUs).
• Current active surveillance cultures (ASCs) for MRSA may be inefficient in ICUs with low MRSA prevalence.
• Identifying risk factors for MRSA carriage is crucial for optimizing screening protocols.

Purpose of the Study:

• To identify risk factors associated with MRSA carriage in ICU patients.
• To develop a clinical predictive model for MRSA carriage.
• To evaluate the cost-effectiveness of a targeted screening strategy.

Main Methods:

• Retrospective analysis of 3927 ICU patients admitted between April 2015 and August 2022.
• MRSA screening using nasal ASCs upon ICU admission.
• Multivariate analysis to identify risk factors and cost analysis of screening strategies.

Main Results:

• The prevalence of MRSA was 3.4% (133/3927 patients).
• Key risk factors for MRSA carriage included age ≥ 50 years, prior hospitalization, and specific ICD-10 code classifications (I, IV, XII).
• Targeted screening based on risk factors achieved 96.9% sensitivity and reduced costs by 10.9% ($4686).

Conclusions:

• Universal MRSA ASCs may not be optimal in low-prevalence ICU settings.
• A targeted screening approach based on identified risk factors can reduce testing volume and costs.
• Further prospective multicenter studies are needed to validate the proposed screening strategy.