title: Root cause analysis of methicillin resistant Staphylococcus aureus bacteraemia.
abstract: OBJECTIVE
  To find the important risk factors and sources of bacteraemia in patients suffering from methicillin-resistant staphylococcus aureus bacteraemia.
  
  
  METHODS
  The descriptive study was carried out at Shaikh Zayed Hospital, Lahore, from October 2010 to August 2011. Blood cultures were processed to isolate methicillin-resistant staphylococcus aureus. A questionnaire was completed by the participating patients suffering from bacteraemia. Information about risk factors present at the time and risk factors that served as the source of bacteraemia were noted.
  
  
  RESULTS
  Total 4058 blood cultures were processed and 669(16.5%) were positive. Of them, 194(29%) cultures were found to be positive for staphylococci. Out of these 194 blood cultures, coagulase-negative staphylococci were isolated from 117(60%), and 77(40%) were positive for S. aureus. Out of these 77 samples, 26(34%) were found to be methicillin-sensitive staphylococcus aureus and 51(66%) were methicillin-resistant staphylococcus aureus. The overall frequency of methicillin-resistant staphylococcus aureus was 1.25%; 7.62% out of positive blood culture; 26.28% out of total staphylococci; and 66% out of total S. aureus. As for the source of infection, central venous pressure line 11(21.6%), post-influenza pneumonia 9(17.6%), peripheral intravenous line 8(15.7%) and dialysis line 7(13.7%) were major reasons.
  
  
  CONCLUSIONS
  Taking care of aseptic measures while insertion, frequent change and early removal of the central venous and dialysis lines is of critical significance.
authors.affiliation: Department of Pathology, Sargodha Medical College, Sargodha.
authors.forename: Nadia
authors.initials: N
authors.lastname: Aslam
authors.affiliation: Department of Pathology, Gujranwala medical college, Gujranwala.
authors.forename: Naima
authors.initials: N
authors.lastname: Mehdi
authors.affiliation: Department of Microbiology, Shaikh Zayed Hospital, Lahore.
authors.forename: Mateen
authors.initials: M
authors.lastname: Izhar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D012307:Risk Factors; D060891:Root Cause Analysis; D013203:Staphylococcal Infections / Q000209:etiology*; D055815:Young Adult
keywords: Bacteraemia, Methicillin, Staphylococcus aureus.