Incidence of Methicillin-Resistant <i>Staphylococcus aureus</i> Nosocomial Infections in Intensive Care Units in Lyon University Hospitals, France, 2003-2006

Moalla, Myriam; Baratin, D; Giard, Marine; Vanhems, Philippe

doi:10.1086/533547

Cited by 7 publications

(3 citation statements)

References 4 publications

(4 reference statements)

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“…44%). The French group noted that this decrease was consistent with the decrease in the number of MRSA-positive blood cultures reported by other French hospitals following the introduction of a national control programme [16] that included active screening in ICU patients. A decrease of 27% has also been reported in the UK for the incidence of MRSA bacteraemia in 2007, which was partially attributed to the introduction and implementation of mandatory surveillance of these infections and the promotion of alcohol-based hand rubs as part of multimodal and system change interventions [17], yet without mandatory universal onadmission screening already implemented.…”

Section: Active Screening Of Mrsa Carriers: Universal or Targeted?supporting

confidence: 60%

Update on screening and clinical diagnosis of meticillin-resistant Staphylococcus aureus (MRSA)

Harbarth

Hawkey

Tenover³

et al. 2011

International Journal of Antimicrobial Agents

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Section: Active Screening Of Mrsa Carriers: Universal or Targeted?supporting

confidence: 60%

Update on screening and clinical diagnosis of meticillin-resistant Staphylococcus aureus (MRSA)

Harbarth

Hawkey

Tenover³

et al. 2011

International Journal of Antimicrobial Agents

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“…The results of this study indicate that MRSA HAP and VAP rates in Canadian hospitals are lower than those reported from a number of other countries. The incidence of MRSA HAP in French ICUs ranged from 0.50-0.90 per 1,000 patient-days [29], and mean VAP rates in US medical/surgical ICUs participating in surveillance conducted by the National Healthcare Safety Network were 0.47-0.59 per 1,000 ventilator-days [30]. A little more than one-quarter (28%) of all the pneumonias identified in our study were thought to have been community-acquired.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Outcome of Pneumonia Caused by Methicillin-Resistant Staphylococcus aureus (MRSA) in Canadian Hospitals

et al. 2013

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BackgroundMRSA remains a leading cause of hospital-acquired (HAP) and healthcare-associated pneumonia (HCAP). We describe the epidemiology and outcome of MRSA pneumonia in Canadian hospitals, and identify factors contributing to mortality.MethodsProspective surveillance for MRSA pneumonia in adults was done for one year (2011) in 11 Canadian hospitals. Standard criteria for MRSA HAP, HCAP, ventilator-associated pneumonia (VAP), and community-acquired pneumonia (CAP) were used to identify cases. MRSA isolates underwent antimicrobial susceptibility testing, and were characterized by pulsed-field gel electrophoresis (PFGE) and Panton-Valentine leukocidin (PVL) gene detection. The primary outcome was all-cause mortality at 30 days. A multivariable analysis was done to examine the association between various host and microbial factors and mortality.ResultsA total of 161 patients with MRSA pneumonia were identified: 90 (56%) with HAP, 26 (16%) HCAP, and 45 (28%) CAP; 23 (14%) patients had VAP. The mean (± SD) incidence of MRSA HAP was 0.32 (± 0.26) per 10,000 patient-days, and of MRSA VAP was 0.30 (± 0.5) per 1,000 ventilator-days. The 30-day all-cause mortality was 28.0%. In multivariable analysis, variables associated with mortality were the presence of multiorgan failure (OR 8.1; 95% CI 2.5-26.0), and infection with an isolate with reduced susceptibility to vancomycin (OR 2.5, 95% CI 1.0-6.3).ConclusionsMRSA pneumonia is associated with significant mortality. Severity of disease at presentation, and infection caused by an isolate with elevated MIC to vancomcyin are associated with increased mortality. Additional studies are required to better understand the impact of host and microbial variables on outcome.

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“…Generally, the incidence density of nosocomial VAP declined (from 5.81 in 2005 to 4.33 VAP per 1000 ventilation days in 2009) but the decline affected all pathogens (from 5.76 in 2005 to 4.21 VAP-pathogens per 1000 ventilation days in 2009). Likewise reported Moalla et al no trends in the incidence of nosocomial MRSA pneumonia in a French University hospital over a period of 4 years: it was 0.9 cases per 1000 patient days in 2003 and was 0.7 in 2006 (p = .26) [36]. …”

Section: Change Over Timementioning

confidence: 98%

Nosocomial methicillin resistant staphylococcus aureus pneumonia - epidemiology and trends based on data of a network of 586 German ICUs (2005-2009)

2010

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The epidemiology of MRSA pneumonia varies across countries. One of the most import risk factors for the development of nosocomial MRSA pneumonia is mechanical ventilation. Methicillin resistance in S. aureus ventilator associated pneumonia (VAP) ranged between 37% in German, 54% in the US American and 78% in Asian and Latin American ICUs. In 2009, the incidence density of nosocomial VAP caused by MRSA was 0.28 per 1000 ventilation days in a network of 586 German ICUs. Incidences peaked in neurological and neurosurgical ICUs. Crude hospital mortality in studies performed after 2005 lay between 27% and 59% and attributable MRSA pneumonia mortality at 40%. Since 2005, US American and German data indicate decreasing trends for MRSA pneumonia. Measures to reduce MRSA pneumonia or to control the spread of MRSA include hand hygiene, standard and contact precautions, oral contamination with chlor hexidine, skin decontamination with antiseptics, screening, and (possibly) patient isolation in a single room.

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Incidence of Methicillin-Resistant Staphylococcus aureus Nosocomial Infections in Intensive Care Units in Lyon University Hospitals, France, 2003-2006

Cited by 7 publications

References 4 publications

Update on screening and clinical diagnosis of meticillin-resistant Staphylococcus aureus (MRSA)

Update on screening and clinical diagnosis of meticillin-resistant Staphylococcus aureus (MRSA)

Epidemiology and Outcome of Pneumonia Caused by Methicillin-Resistant Staphylococcus aureus (MRSA) in Canadian Hospitals

Nosocomial methicillin resistant staphylococcus aureus pneumonia - epidemiology and trends based on data of a network of 586 German ICUs (2005-2009)

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