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Acquisition of Methicillin-Resistant Staphylococcus aureus in a Large Intensive Care Unit

Published online by Cambridge University Press:  02 January 2015

Caroline Marshall ,
Glenys Harrington ,
Rory Wolfe ,
Christopher K. Fairley ,
Steve Wesselingh  and
Denis Spelman
Caroline Marshall*
Affiliation:
Department of Epidemiology & Preventive Medicine, Monash University, Prahran, Victoria, Australia
Glenys Harrington
Affiliation:
Infection Control & Hospital Epidemiology Unit, The Alfred Hospital, Prahran, Victoria, Australia
Rory Wolfe
Affiliation:
Department of Epidemiology & Preventive Medicine, Monash University, Prahran, Victoria, Australia
Christopher K. Fairley
Affiliation:
Department of Public Health, University of Melbourne, Victoria, Australia
Steve Wesselingh
Affiliation:
Infectious Diseases Unit, The Alfred Hospital, Monash University, Prahran, Victoria, Australia
Denis Spelman
Affiliation:
Infectious Diseases Unit, The Alfred Hospital, Monash University, Prahran, Victoria, Australia
*
Department of Epidemiology & Preventive Medicine, Central and Eastern Clinical School, The Alfred Hospital, Melbourne, 3004, Australia
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Abstract

Objectives:

To determine the prevalence of MRSA colonization on admission to the ICU and the incidence of MRSA colonization in the ICU.

Design:

Prospective cohort study.

Setting:

University hospital.

Participants:

Patients admitted to the ICU in 2000-2001.

Methods:

Patients were screened for MRSA with nose, throat, groin, and axilla swabs on admission and discharge. MRSA acquisition was defined as a negative admission screen and a positive discharge screen. Risk factors analyzed included previous wards/current unit, gender, age, and length of stay prior to and in the ICU. Univariate and multivariate analyses were performed using logistic regression.

Results:

Of screened patients, 6.8% were MRSA colonized on admission to the ICU. Some patients (11.4%) became newly colonized during their stay in the ICU. Factors that remained significant in the multivariate analysis of MRSA colonization on admission were previous admission to various wards and length of stay prior to ICU admission of more than 3 days. In the multivariate analysis of MRSA acquisition in the ICU, being a trauma patient and length of stay in the ICU greater than 2 days remained significant. Thirty-six percent of patients had both admission and discharge swabs taken. This percentage increased in the presence of a supervisory nurse.

Conclusion:

Significant acquisition of MRSA occurs in the ICU of our hospital, with trauma patients at increased risk. Patients who had been on the cardiothoracic ward prior to the ICU had a lower risk of MRSA colonization on admission. Presence of a supervisory nurse improved compliance with screening.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 5 , May 2003 , pp. 322 - 326
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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