Methicillin-resistantStaphylococcus aureusnasal colonization and infection in an intensive care unit of a university hospital in China

Abstract

ObjectiveThis study was performed to determine the prevalence and risk factors associated with nasal methicillin-resistant Staphylococcus aureus (MRSA) colonization upon intensive care unit (ICU) admission and during the ICU stay in mainland China.MethodsA prospective observational study was performed in a 50-bed general ICU of a 4300-bed teaching hospital in China from 2011 to 2013. Nasal swabs for MRSA detection were obtained upon ICU admission and at discharge for patients having stayed in the ICU for longer than 3 days.ResultsIn total, 115 patients (4.1%; 95% confidence interval [CI], 3.4–4.9) were already colonized with MRSA on ICU admission, and another 185 patients (10.7%; 95% CI, 9.3–12.2) acquired MRSA during their ICU stay. Development of an MRSA infection was significantly more likely in patients with than without MRSA colonization on ICU admission (odds ratio [OR], 2.8; 95% CI, 1.1–7.3). Patients who acquired MRSA had significantly prolonged lengths of stay in the ICU (23.3 days) and higher hospital bills (135,171 RMB; about 19,590 USD) than those who tested negative for MRSA.ConclusionThe MRSA colonization rate among ICU patients in mainland China is high. Patients with MRSA-positive nasal swabs are more likely to develop MRSA infections.

Impact of Deficiencies in Branched-Chain Fatty Acids and Staphyloxanthin inStaphylococcus aureus

“…Prevalence of the bacterium S. aureus in the environment facilitates colonization on human skin, nares, and other exposed tissues. Colonized individuals are at a greater risk of progressing to clinical infections [24–26]. Pathogenic bacteria, such as S. aureus , continuously face conditions that are hostile to their existence in the environment.…”

Fatores associados à infecção por Staphylococcus aureus resistente à meticilina em unidade de terapia intensiva

“…In this context, it is worth emphasizing the importance of the isolation measures for infected patients, which include hand washing with antiseptics, isolation, use of own materials and subsequent disinfection or disposal, personal protective equipment for professionals, and decolonization measures such as: bathing using chlorhexidine on the body and hair, use of 2% mupirocin where MRSA was isolated, exchange of invasive catheters and monitoring of colonization by the pathogen (31) . To be continued However, there are studies showing that the discontinuation of contact precautions for patients with MRSA, along with the daily chlorhexidine bath, is associated with increased MRSA infection (32) .…”

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“…Especially important are those that are resistant to two or more antimicrobial agents that belong to different types. Among those, S. aureus has become relevant because it is responsible for many intrahospitalary and community infections and is associated with an increment of morbidity and mortality in intensive care units 1,2 . Methicillinresistant S. aureus (MRSA) is becoming isolate with increased frequency since 1961, and it has developed resistance to non-beta-lactam antibiotics as well, like vancomycin 3,4 .…”