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[Dynamics of the nasal colonization by methicillin resistant Staphylococcus aureus in patients hospitalized in an
M Mounier1, M C Ploy, B François
1Service de Bactériologie-Virologie-Hygiène, CHU Dupuytren, Limoges, France.
Abstract:
Prospective study on MRSA nasal cariage was done during two months in an intensive care unit in Limoges University Hospital. Nasal swab specimens were taken daily and cultured on selective and non selective media. Sixty eight patients were included in this study (878 swab collected, 575 MRSA isolated). Patients mean âge was 62 years and stay period mean was 12.3 days (median: 7 days). Among these patients, 16 were already carrying MRSA when entering in the unit and 26 became positive for MRSA during their stay. The mean colonisation delay was 5.5 days (median 4 days). All patients, except one, have shown a nasal carriage during all their stay. During the study period, 17 patients became infected and only two patients neither carried nasal MRSA before and during infection. In all cases, glycopeptide treatment did not affect nasal carriage. Colonisation and infection risk factors were discussed.
Insights
This study investigated Methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage in intensive care unit patients. MRSA nasal carriage was common and persistent, with glycopeptide treatment showing no effect on colonization.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Context:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings, particularly in intensive care units (ICUs).
- Understanding MRSA nasal carriage dynamics is crucial for infection control strategies.
- This prospective study was conducted in the Limoges University Hospital ICU.
Purpose:
- To investigate the prevalence and duration of MRSA nasal carriage in ICU patients.
- To identify potential risk factors for MRSA colonization and infection.
- To evaluate the impact of glycopeptide treatment on MRSA nasal carriage.
Summary:
- A two-month prospective study included 68 ICU patients, collecting 878 nasal swabs.
- MRSA nasal carriage was observed in 42 patients (16 pre-existing, 26 acquired during stay), with carriage often persisting throughout their ICU stay.
- 17 patients developed MRSA infections; glycopeptide treatment did not influence nasal carriage.
Impact:
- Highlights the high prevalence and persistence of MRSA nasal carriage in ICUs, emphasizing the need for robust infection control measures.
- Provides insights into colonization and infection risk factors, aiding in targeted prevention strategies.
- Demonstrates the ineffectiveness of glycopeptide treatment in eradicating MRSA nasal carriage, suggesting alternative approaches may be necessary.