Related Experiment Videos
[Methicillin-resistant staphylococci in pediatric resuscitation]
A Pigna1, M Pirazzini, G Grillione
1Servizio di Anestesia e Rianimazione, Policlinico S. Orsola-Malpighi, Bologna.
Objective:
To evaluate the incidence of colonization and infection by methicillin-resistant in PICU.
Design:
Prospective cohort study during 2 years for the surveillance of nosocomial infections.
Setting:
Four beds Pediatric Intensive Care Unit.
Patients:
We studied two-hundred patients with duration of hospitalization longer than 24 hours out of the 255 patients who were hospitalized during the same period.
Methods:
The patients were divided in two groups according to the presence or the absence of MRS. The difference of the two populations were compared using the t-test and the CATANOVA: Wilcoxon's test was used to analyze the relation between the two values. The results were significant when p = 0.05 and Ct = 3.81.
Results:
Fourty patients (20%) were colonized or infected by MRS with two seasonal peaks which were not correlated with the amount of index work. Nine patients were already colonized at entrance in PICU (4.5%) and the rate of infected patients versus infections was 1.5% (3 patients with 3 clinical manifestations). The presence of MRS in the different sections of the hospital could be shown. The rate of PICU-acquired colonization was 12.5% (25), the rate of PICU-acquired infected patients was only 2% (4), the infections rate was 3.5% (7 events). The average time which occurred the colonization by MRS to happen was 10,1 days from the day of hospitalization on, which is longer than that of the other germs (p = 0.001). Clinically the infection by MRS was localized as follows: 3 septicemiae, 2 pneumoniae and 2 muco-cutaneous infections. Most the patients with carriage of the MRS were prematures or newborns who had a long stay in PICU, who underwent invasive diagnostic and therapeutic treatment and who had a previously long stay in other department of the hospital. The stay in the PICU lasted longer in those patients who had a MRS carriage. They furthermore had a lower mortality rate (12.5%) than the other patients (Cc = 0.976); the 4 infected patients survived.
Conclusions:
The clinical impact of MRS in terms of morbidity and mortality in this PICU is modest. The prevention and limitation of the spread of MRS could be obtained by simple but essential measures of control.
Insights
Methicillin-resistant Staphylococcus aureus (MRS) colonization or infection impacts 20% of pediatric intensive care unit patients, with a modest clinical effect. Simple control measures can prevent and limit MRS spread.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Context:
- Nosocomial infections surveillance in a Pediatric Intensive Care Unit (PICU).
- Evaluation of Methicillin-resistant Staphylococcus aureus (MRS) colonization and infection rates.
- Study conducted over two years in a four-bed PICU.
Purpose:
- To determine the incidence of MRS colonization and infection in a PICU.
- To compare patient outcomes based on MRS presence.
- To identify risk factors and clinical manifestations of MRS in critically ill children.
Summary:
- A prospective cohort study of 200 pediatric patients found a 20% incidence of MRS colonization or infection.
- PICU-acquired colonization occurred in 12.5% of patients, with infections in 2%.
- MRS carriage was associated with longer PICU stays but a lower mortality rate.
Impact:
- The clinical impact of MRS in this PICU is modest regarding morbidity and mortality.
- Findings suggest that simple control measures are effective in preventing and limiting MRS spread.
- Highlights the importance of surveillance and infection control in pediatric critical care settings.