Methicillin-resistant Staphylococcus aureus in a surgical intensive care unit.
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.
Recinos
Gustavo
G
Division of Trauma and Surgical Critical Care, Los Angeles County, University of Southern California Medical Center, Los Angeles, California 90033-4525, USA.
Inaba
Kenji
K
Dubose
Joseph
J
Barmparas
Galinos
G
Teixeira
Pedro G R
PG
Talving
Peep
P
Belzberg
Howard
H
Demetriades
Demetrios
D
D000328:Adult; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D003422:Critical Care / Q000706:statistics & numerical data*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D015995:Prevalence; D012189:Retrospective Studies; D013022:South Carolina / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000601:surgery*