Related Experiment Videos
Methicillin-resistant Staphylococcus aureus: acquisition and risk of death in patients in the intensive care unit
1Department of Surgery, University Hospital Rotterdam Dijkzigt, The Netherlands.
Objective:
To evaluate the risk of patients in intensive care units (ICU) of becoming infected with methicillin-resistant Staphylococcus aureus (MRSA) and to assess the mortality during a six week follow-up period, compared with patients who developed methicillin-sensitive S. aureus (MSSA) infection.
Design:
Point prevalence survey.
Setting:
1417 ICU in 17 Western European countries.
Subjects:
10038 patients in ICU who were part in the EPIC (European Prevalence of Infection in Intensive Care) Study.
Main Outcome Measures:
Prevalence of MRSA and MSSA ICU-acquired infections, risk factors, and mortality.
Results:
On the study day 21% of patients had ICU-acquired infections. The most commonly reported pathogen was Staphylococcus aureus (30%). Overall, 60% of strains of S. aureus were resistant to methicillin (with a wide intercountry variation). The most commonly reported MRSA infections were pneumonia and lower respiratory tract infections. The most important risk factor for MRSA was the length of stay in the ICU. MRSA infection reduced the chance of survival, particularly when it was found in lower respiratory tract infections: the risk of mortality was three times higher in patients with MRSA than in those with MSSA.
Conclusion:
Patients in ICU are at high risk of becoming infected with MRSA. The longer they stay, the higher the risk. Patients with MRSA infections are less likely to survive than those with MSSA.
Insights
Intensive care unit patients face a high risk of methicillin-resistant Staphylococcus aureus (MRSA) infection, with longer stays increasing this danger. MRSA significantly raises mortality risk compared to methicillin-sensitive S. aureus (MSSA) infections.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- Intensive care units (ICUs) are high-risk environments for healthcare-associated infections.
- Staphylococcus aureus is a common pathogen, with methicillin-resistant strains (MRSA) posing a significant threat.
Purpose of the Study:
- To determine the risk of MRSA infection in ICU patients.
- To compare mortality rates between MRSA and methicillin-sensitive S. aureus (MSSA) infected patients.
Main Methods:
- A point prevalence survey was conducted.
- Data from 10,038 patients across 1417 ICUs in 17 Western European countries were analyzed (EPIC Study).
- Prevalence, risk factors, and mortality of ICU-acquired MRSA and MSSA infections were assessed.
Main Results:
- 21% of patients had ICU-acquired infections; Staphylococcus aureus was the most common pathogen (30%).
- 60% of S. aureus strains were MRSA, with significant intercountry variation.
- Increased length of stay in ICU was the primary risk factor for MRSA. MRSA infection tripled the mortality risk, especially for lower respiratory tract infections.
Conclusions:
- ICU patients are at substantial risk for MRSA infections.
- Prolonged ICU stays correlate with higher MRSA risk.
- MRSA infections are associated with poorer survival outcomes compared to MSSA infections.