Methicillin-resistant Staphylococcus aureus nosocomial infection trends in Hospital Universiti Sains Malaysia during 2002-2007.
OBJECTIVE
Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity and mortality in many hospitals worldwide. The aim of the present study was to assess the burden of MRSA nosocomial infection, its association with factors of interest, and its antimicrobial susceptibility.


METHODS
This was a retrospective analysis of a database of all S aureus that were cultured from patients admitted to the different wards of Hospital Universiti Sains Malaysia (HUSM) over a period of 6 years.


RESULTS
The MRSA infections rate was 10.0 per 1000 hospital admissions. The incidence density rate of MRSA infections during the study period was 1.8 per 1000 patient-days, with annual rates ranging from 0.95 to 3.47 per 1000 patient-days. Duration of hospitalization, previous antibiotic use, and bedside invasive procedures were significantly higher among MRSA than methicillin-sensitive S aureus patients (P>.05). The highest number of MRSA infections were found in orthopedic wards (25.3%), followed by surgical wards (18.2%) and intensive care units (ICUs) (16.4%). All MRSA isolates were resistant to erythromycin (98.0%), co-trimoxazole (94.0%) and gentamicin (92.0%). Clindamycin was the best antibiotic with only 6% resistance. All MRSA isolates were sensitive to vancomycin.


CONCLUSIONS
The rate of nosocomial MRSA infection per 1000 admissions was higher than that in other studies. The three factors associated most significantly with acquired MRSA infections included duration of hospitalization, antibiotic use, and bedside invasive procedures. This study confirmed that vancomycin-resistant S aureus has not yet been established in HUSM.
Al-Talib
Hassanain I
HI
Department of Medical Microbiology, School of Medical Sciences Malaysia, Kubang Kerian, Kelantan, Malaysia.
Yean
Chan Y
CY
Al-Jashamy
Karim
K
Hasan
Habsah
H
D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D018562:Disease Transmission, Infectious / Q000706:statistics & numerical data*; D004917:Erythromycin / Q000494:pharmacology; D005260:Female; D005839:Gentamicins / Q000494:pharmacology; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D016015:Logistic Models; D008296:Malaysia / Q000453:epidemiology; D055624:Methicillin-Resistant Staphylococcus aureus; D008826:Microbial Sensitivity Tests; D010400:Penicillin G / Q000494:pharmacology; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology; D014640:Vancomycin / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D004917:Erythromycin; D014640:Vancomycin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D010400:Penicillin G