title: Prevalence and risk factors of MRSA, ESBL and MDR bacterial colonization upon admission to an Egyptian medical ICU.
abstract: BACKGROUND
  Bacterial colonization of the skin and mucous membranes of intensive care unit (ICU) patients with virulent organisms such as methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase (ESBL) producers, and multidrug-resistant Gram-negative bacteria (MDR-GNB) frequently results in life-threatening infections. Universal screening of ICU patients upon admission has been suggested. The aim of the current study was to evaluate the prevalence and pattern of MRSA, ESBL, and MDR-GNB colonization in patients upon admission to an Egyptian medical ICU, along with the related demographic and clinical risk factors.
  
  
  METHODS
  Throat, axillary, and groin swabs were obtained from all study participants in addition to rectal swabs from consenting patients. These swabs were screened for MRSA, ESBL, and MDR-GNB.
  
  
  RESULTS
  Of the patients included in the study, 33%, 13%, and 63% were colonized with ESBL, MDR-GNB, and MRSA organisms, respectively. Those suffering from a more severe disease with a simplified acute physiology score II (SAPS II) > 29 demonstrated higher levels of MDR-GNB colonization upon admission, while MDR-GNB or ESBL colonization upon admission was associated with higher ICU mortality.
  
  
  CONCLUSIONS
  Colonization of ICU patients with superbugs upon admission has an impact on outcome and mortality. In this Egyptian example, colonization rates were higher than in other literature reports, demonstrating the need for routine screening and decolonization, if applicable.
authors.affiliation: Kasr El Aini Faculty of Medicine, Cairo, Egypt. ragaifouda@yahoo.com.
authors.forename: Ragai
authors.initials: R
authors.lastname: Fouda
authors.forename: May Sherif
authors.initials: MS
authors.lastname: Soliman
authors.forename: Mervat Gaber
authors.initials: MG
authors.lastname: ElAnany
authors.forename: Maggie
authors.initials: M
authors.lastname: Abadeer
authors.forename: Ghada
authors.initials: G
authors.lastname: Soliman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D004534:Egypt / Q000453:epidemiology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D006119:Groin / Q000382:microbiology; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000382:microbiology; D015995:Prevalence; D011446:Prospective Studies; D012007:Rectum / Q000382:microbiology; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult