Reduction in Inddence of Nosocomial Methicillin-Resistant Staphylococcus aureus (MRSA) Infection in an Intensive Care Unit: Role of Treatment With Mupirocin Ointment and Chlorhexidine Baths for Nasal Carriers of MRSA

2006 ◽  
Vol 27 (2) ◽  
pp. 185-187 ◽  
Author(s):  
Ana Maria Sandri ◽  
Micheline Gisele Dalarosa ◽  
Luciana Ruschel de Alcântara ◽  
Laura da Silva Elias ◽  
Alexandre Prehn Zavascki
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Tertiary Care ◽  
Methicillin Resistant ◽  
Nasal Carrier ◽  
Mrsa Infection ◽  
Mupirocin Ointment

After the introduction of routine treatment for every nasal carrier of methicillin-resistant Staphylococcus aureus, active follow-up surveillance for nosocomial methicillin-resistant S. aureus infection was conducted for 5 years in an intensive care unit of a tertiary-care teaching hospital. There was a significant decrease in the incidence of nosocomial methicillin-resistant S. aureus infection during the later years of follow-up. Decolonization of nasal carriers of methicillin-resistant S. aureus is probably associated with such findings.

The Role of Negative Methicillin-Resistant Staphylococcus aureus Nasal Surveillance Swabs in Predicting the Need for Empiric Vancomycin Therapy in Intensive Care Unit Patients

2018 ◽  
Vol 39 (3) ◽  
pp. 290-296 ◽  
Author(s):  
Darunee Chotiprasitsakul ◽  
Pranita D. Tamma ◽  
Avinash Gadala ◽  
Sara E. Cosgrove
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Nasal Swab ◽  
Vancomycin Therapy ◽  
Methicillin Resistant ◽  
Nasal Swabs ◽  
Mrsa Infection

OBJECTIVESThe role of methicillin-resistant Staphylococcus aureus (MRSA) nasal surveillance swabs (nasal swabs) in guiding decisions about prescribing vancomycin is unclear. We aimed to determine the likelihood that patients with negative MRSA nasal swabs develop subsequent MRSA infections; to assess avoidable vancomycin days for patients with negative nasal swabs; and to identify risk factors for having a negative nasal swab and developing a MRSA infection during the intensive care unit (ICU) stay.METHODSThis retrospective cohort study was conducted in 6 ICUs at a tertiary-care hospital from December 2013 through June 2015. The negative predictive value (NPV), defined as the ability of a negative nasal swab to predict no subsequent MRSA infection, was calculated. Days of vancomycin continued or restarted after 3 days from the collection time of the first negative nasal swab were determined. A matched case-control study identified risk factors for having a negative nasal swab and developing MRSA infection.RESULTSOf 11,441 patients with MRSA-negative nasal swabs, the rate of subsequent MRSA infection was 0.22%. A negative nasal swab had a NPV of 99.4% (95% confidence interval [CI], 99.1%–99.6%). Vancomycin was continued or started after nasal swab results were available in 1,431 patients, translating to 7,364 vancomycin days. No risk factors associated with MRSA infection were identified.CONCLUSIONSIn our hospital with a low prevalence of MRSA transmission, a negative MRSA nasal swab was helpful in identifying patients with low risk of MRSA infection in whom empiric vancomycin therapy could be stopped and in whom the subsequent initiation of vancomycin therapy during an ICU admission could be avoided.Infect Control Hosp Epidemiol 2018;39:290–296

scholarly journals Community-associated methicillin-resistant Staphylococcus aureus infections in a pediatric intensive care unit

2011 ◽  
Vol 5 (08) ◽  
pp. 587-591 ◽  
Author(s):  
Khaled Menif ◽  
Asma Bouziri ◽  
Ammar Khaldi ◽  
Asma Hamdi ◽  
Sarra Belhadj ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Pediatric Intensive Care ◽  
Retrospective Chart Review ◽  
Pulmonary Involvement ◽  
Methicillin Resistant ◽  
Mrsa Infection

Introduction: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection is an increasing problem worldwide. In developing countries, there is little data on CA-MRSA infection in children. This study reviewed the clinical features and outcomes of children admitted in a Tunisian pediatric intensive care unit with severe CA-MRSA infections. Methodology: Retrospective chart review of patients coded for CA-MRSA over 10 years. Results: There were 14 (0.32% of all admissions) patients identified with severe CA-MRSA infections. The median age was three months (range, 0.5-156 months). All patients had pulmonary involvement. Six children (42.8%) developed septic shock. Two (14.3%) patients had multifocal infection with deep venous thrombosis. Two (14.3%) patients died. Conclusions: Severe CA-MRSA pneumonia dominated presentation. The mortality of CA-MRSA infection in our series is lower than that previously reported.

Effectiveness of Simple Measures to Control an Outbreak of Nosocomial Methicillin-Resistant Staphylococcus aureus Infections in an Intensive Care Unit

1990 ◽  
Vol 11 (1) ◽  
pp. 23-26 ◽  
Author(s):  
M. Guiguet ◽  
C. Rekacewicz ◽  
B. Leclercq ◽  
Y. Brun ◽  
B. Escudier ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Index Case ◽  
Sharp Decrease ◽  
Control Measures ◽  
Methicillin Resistant ◽  
Contact Isolation ◽  
Mrsa Infection

AbstractBetween June 1985 and March 1986, 14 cases of severe nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection, including septicemia, were observed in the intensive care unit (ICU) of a 400-bed cancer reference center. Simple control measures including contact isolation of colonized patients and reinforcement of handwashing practices among personnel were followed by a sharp decrease in the rate of infection and colonization. An epidemiological investigation showed that a single serophage variant MRSA strain was involved; peak incidence of infection was 17 per 100 ICU patient discharges; the index case was identified as a patient admitted from another hospital and the epidemic strain was then transmitted from patient-to-patient in the ICU; risk factors for acquiring infection were length of prior hospitalization, invasive procedures and number of antibiotic treatments; dissemination of the strain to other wards was only anecdotal. These results stress the effectiveness of simple measures to control outbreaks of MRSA nosocomial infections even in immunocompromised cancer patients.

Methicillin-Resistant Staphylococcus Aureus in a Surgical Intensive Care Unit

2009 ◽  
Vol 75 (11) ◽  
pp. 1077-1080
Author(s):  
Gustavo Recinos ◽  
Kenjii Naba ◽  
Joseph Dubose ◽  
Galinos Barmparas ◽  
Pedro G.R. Teixeira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Surgical Intensive Care Unit ◽  
Trauma Patients ◽  
Surgical Intensive Care ◽  
Methicillin Resistant ◽  
Positive Culture Result ◽  
Mrsa Infection

The rate of methicillin-resistant Staphylococcus aureus (MRSA) infections has increased significantly over the last years, especially from community-associated MRSA (CA-MRSA) sources. The true prevalence of these multidrug-resistant infections among the trauma patient population, however, is not well defined. A retrospective review of our surgical intensive care unit (SICU) database from April 2003 to April 2007 was performed to identify all trauma patients surviving 48 hours or more that had a positive culture result during their SICU stay. The results of the cultures were examined. A total of 582 SICU patients with 2,860 cultures were assessed for MRSA infection. Among these, 368 cultures (12.9%) in 36 patients were reported as MRSA positive. Thirteen of these patients fulfilled the criteria for a CA-MRSA infection. When outcomes were analyzed, no significant difference in mortality (8.7% vs 15.4%, P = 0.540) or hospital related charges ($364,231 ± 323,719 vs $242,458 ± 276,630, P = 0.091) was noted. Patients with a hospital-acquired MRSA infection, however, had longer hospital lengths of stay (42.7 ± 47.1 vs 25.3 ± 31.1, P = 0.037) than their community-associated counterparts. MRSA constitutes an important source of infection among critically ill trauma patients. CA-MRSA organisms may play an increasing pathogenic role in this population.

Father-to-Infant Transmission of Community-Acquired Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive Care Unit

2006 ◽  
Vol 27 (6) ◽  
pp. 636-637 ◽  
Author(s):  
Jaffar A. Al-Tawfiq
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Treatment Options ◽  
Hospital Setting ◽  
Neonatal Intensive Care Units ◽  
Methicillin Resistant ◽  
Mrsa Infection

Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly being recognized as a cause of community-acquired infection. Its transmission in neonatal intensive care units (NICUs) has reportedly been linked to a few cases of community-acquired MRSA (CA-MRSA) infection. Here, I describe a case of CA-MRSA transmission from a father to his child in a NICU. Recognition that CA-MRSA may be transmitted in a hospital setting raises important issues for MRSA infection control and treatment options.

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