Healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) infection in intensive care unit (ICU) patients prolongs ICU stay and causes high mortality. Predicting HA-MRSA infection on admission can strengthen precautions against MRSA transmission. Kazuma Yamakawa of the Department of Emergency and Critical Care at Osaka General Medical Center in Osaka, Japan, and colleagues, sought to clarify the risk factors for HA-MRSA infection in an ICU from data obtained within 24 hours of patient ICU admission.
The researchers prospectively studied HA-MRSA infection in 474 consecutive patients admitted for more than two days to the medical, surgical and trauma ICU in a tertiary referral hospital in Japan. Data obtained from patients within 24 hours of ICU admission on 11 prognostic variables possibly related to outcome were evaluated to predict infection risk in the early phase of ICU stay. Stepwise multivariate logistic regression analysis was used to identify independent risk factors for HA-MRSA infection.
Thirty patients (6.3 percent) had MRSA infection, and 444 patients (93.7 percent) were infection-free. Intubation, existence of open wound, treatment with antibiotics, and steroid administration, all occurring within 24 hours of ICU admission, were detected as independent prognostic indicators. Patients with intubation or open wound comprised 96.7 percent of MRSA-infected patients but only 57.4 percent of all patients admitted.
The researchers concluded that four prognostic variables were found to be risk factors for HA-MRSA infection in ICU: intubation, open wound, treatment with antibiotics, and steroid administration, all occurring within 24 hours of ICU admission. Preemptive infection control in patients with these risk factors might effectively decrease HA-MRSA infection. Their research was published in BMC Infectious Diseases.
Reference: Yamakawa K, et al. Assessment of risk factors related to healthcare-associated methicillin-resistant Staphylococcus aureus infection at patient admission to an intensive care unit in Japan. BMC Infectious Diseases 2011, 11:303 doi:10.1186/1471-2334-11-303