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[Methicillin-reistant Staphylococcus aureus: risk factors for infection-colonization and clonal heterogeneity in
T A Wichelhaus1, K Westphal, P Kessler
1Institut für Medizinische Mikrobiologie, J. W. Goethe-Universität Frankfurt am Main.
Purpose:
The aim of this study was to determine the risk factors associated with colonisation/infection by methicillin-resistant Staphylococcus aureus (MRSA) and to demonstrate the chain of infections by genotyping of all MRSA isolates.
Methods:
A total of 6143 microbiological samples from 1753 patients was obtained at a surgical ICU of Frankfurt University hospital during 1995.
Results:
MRSA was detected in 1.6% of patients and three members of staff (3.3%). Typing of these 31 MRSA-strains (first isolates) by macrorestriction analysis of chromosomal DNA revealed nine different genotypes. More than 60% of all isolates belonged to one type that was confirmed to be closely related to the "South Germany" epidemic strain. A strong correlation between severity of underlying disease and length of hospitalisation on the one hand and detection of MRSA on the other could be demonstrated. Detection of MRSA was significantly more common in patients with adult respiratory distress syndrome (ARDS), sepsis, kidney failure, prolong respiratory treatment and in patients with prolonged phases of haemodynamic instability. It appeared that the mortality rate of MRSA-infected patients was higher (28.6%) than the mortality rate of all patients (6.5%).
Conclusion:
Following of a strict hygiene regime is important to prevent clonal spread of MRSA and especially to protect immunocompromised patients from complicating infections.
Insights
Strict hygiene is crucial to prevent methicillin-resistant Staphylococcus aureus (MRSA) spread, especially in intensive care units. This study identified patient factors like ARDS and sepsis correlating with MRSA detection.
Area of Science:
- Medical Microbiology
- Infectious Disease Epidemiology
Context:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings.
- Surgical intensive care units (ICUs) are high-risk environments for MRSA transmission.
Purpose:
- To identify risk factors for MRSA colonization/infection in a surgical ICU.
- To elucidate MRSA transmission chains through molecular genotyping.
- To assess the impact of MRSA on patient outcomes.
Summary:
- MRSA was detected in 1.6% of patients and 3.3% of staff in a Frankfurt University hospital surgical ICU in 1995.
- Genotyping revealed nine distinct MRSA strains, with one predominant type linked to the
- South Germany
- epidemic strain.
- MRSA detection strongly correlated with severe underlying conditions (e.g., ARDS, sepsis, kidney failure) and prolonged hospitalization.
Impact:
- MRSA-infected patients exhibited a higher mortality rate (28.6%) compared to the overall patient mortality (6.5%).
- Findings underscore the importance of stringent hygiene protocols to prevent clonal spread and protect vulnerable patients.