MRSA In Intensive Care Unit Research Articles

Biofilm formation and molecular characterization of methicillin-resistant Staphylococcus aureus strains isolated from the patients, personnel, air and environment of ICUs

The emergence of hospital-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) as a main cause of nosocomial infections is a global health problem. The present study was conducted to reveal the prevalence of MRSA in intensive care units (ICUs) based on biofilm formation ability and genetic diversity in agr and coa genes. A total of 85 MRSA isolates were analyzed by molecular typing of agr and coa genes from different clinical sources in ICUs using Multiplex PCR and PCR-RFLP methods, respectively. Biofilm formation of all MRSA isolates was investigated using phenotypic and genomic methods. Among 85 isolated MRSA, majority of isolates were belonged to agr type I (71.8%) followed by agr types II (7.1%). PCR-RFLP coa typing revealed 5 different coa types and 13 RFLP patterns. Meanwhile, 51.8% of isolates were strong biofilm formative which were among hospitalized patients 54.5%, and medical staff 75%. Additionally, among 85 MRSA isolates, 60 (70.6%) and 53 (62.4%) isolates had icaA and icaD genes respectively. Moreover 39 (45.9%) of MRSA isolates had both genes, while 11 (13%) isolates had no studied genes. Based on our findings there is no correlation between biofilm formation and the presence of specific types of the agr and coa genes among MRSA clinical isolates. In conclusion, genetic diversity in agr and coa types indicated the presence of various clones of MRSA in our studied ICUs. High prevalence of MRSA strains with agr type I and strong ability of biofilm formation could be most considered as necessity of performance effective infection control policy.

High Frequency of Methicillin-Resistant Staphylococcus aureus in Intensive Care Unit in Karaj, Iran

Objectives: The current study aimed at finding the frequency of MRSA infections, contamination, and colonization in the teaching hospitals of Karaj city, Iran for the first time. Methods: The current cross sectional study was conducted in Karaj on three teaching hospitals from July 2013 to July 2014. Sample collection from personnel and surfaces was conducted twice and monthly, respectively, during the study period. Also, all Staphylococcus aureus species isolated from patients were included in the study. Antimicrobial susceptibility test was performed by the standard disk diffusion method. All isolates were subjected to mupA and mecA-specific polymerase chain reaction (PCR)to identify high-level mupirocin-resistant and MRSA isolates, respectively. Chi-square test was employed for data analysis. Results: The majority of S. aureus species were isolated from personnel and surfaces of the hospitals. One hundred sixty-eight S. aureus and 49 MRSA species were isolated from Karaj teaching hospitals. The main frequency of MRSA was isolated from intensive care unit (ICU) (75%) and high rate of resistance to rifampicin (53%) was observed in MRSA isolates. Although 10 S. aureus species were resistant to mupirocin by disk diffusion, no mupA gene was detected in the isolates. Conclusions: In conclusion, in comparison with the other studies from Iran, low frequency of MRSA was observed in the investigated hospitals. However high frequency (75%) of MRSA in ICU indicated that antibiotic policy is urgently needed to prevent the resistance development. Moreover, antibiotic susceptibility monitoring and regular screening surfaces and personnel of hospitals in terms of MRSA colonization, especially ICU, are indispensable.

Contribution of acquired meticillin-resistant Staphylococcus aureus bacteraemia to overall mortality in a general intensive care unit

During a period of 11 years, 77 patients had meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia > or =5 days after admission to the intensive care unit (ICU). Ten had no prior growth of MRSA, 13 had positive screens on admission and 54 initially tested negative for MRSA in ICU before positive blood culture. These 54 constituted 20.2% [95% confidence interval (CI): 15.6-25.0] of 267 who acquired MRSA > or =5 days after admission. Mortality among 77 patients with MRSA bacteraemia was 57.1% (46.0-68.2). Nineteen of these 77 patients with MRSA bacteraemia had growth of a second pathogen from blood. Those with only MRSA bacteraemia were each matched with five controls by diagnosis and initial Acute Physiological and Chronic Health Evaluation II score. Mortality was greater in bacteraemic patients [53.6% (40.5-66.7)] than in controls [31.8% (26.3-37.3)] [relative risk (RR) 1.69 (1.25-2.26), P < 0.01], implying an additional absolute mortality of 21.8% (8.0-40.1). Application of this estimate to all 77 patients suggests that ICU-acquired MRSA bacteraemia caused 17 (6-31) deaths, adding 0.3% (0.1-0.6) to the 30.1% hospital mortality of all admissions. Incidence of MRSA bacteraemia increased with length of stay, contributing an estimated 3.1% (1.1-5.7) towards 37.9% mortality of the 198 patients remaining > or =25 days. These data emphasise the importance of preventing initial MRSA colonisation/infection of long-stay patients.

Isolation of Patients in Single Rooms or Cohorts to Reduce Spread of MRSA in Intensive-Care Units: Prospective Two-Centre Study

Isolation of Patients in Single Rooms or Cohorts to Reduce Spread of MRSA in Intensive-Care Units: Prospective Two-Centre Study

Isolation of Patients in Single Rooms or Cohorts to Reduce Spread of MRSA in Intensive-Care Units: Prospective Two-Centre Study

Isolation of Patients in Single Rooms or Cohorts to Reduce Spread of MRSA in Intensive-Care Units: Prospective Two-Centre Study

Isolation of Patients in Single Rooms or Cohorts to Reduce Spread of MRSA in Intensive-Care Units: Prospective Two-Centre Study

Isolation of Patients in Single Rooms or Cohorts to Reduce Spread of MRSA in Intensive-Care Units: Prospective Two-Centre Study

Isolation of Patients in Single Rooms or Cohorts to Reduce Spread of MRSA in Intensive Care Units: Prospective Two Centre Study

Isolation of Patients in Single Rooms or Cohorts to Reduce Spread of MRSA in Intensive Care Units: Prospective Two Centre Study

Does isolation prevent the spread of methicillin-resistant Staphylococcus aureus?

Cepeda JA, Whitehouse T, Cooper B, Hails J, Jones K, Kwaku F, et al. Isolation of patients in single rooms or cohorts to reduce spread of MRSA in intensive-care units: prospective two-centre study. Lancet 2005;365(9456):295-304. Background: Hospital management of patients infected with or colonized

Controlling meticillin-resistant Staphylococcus aureus, aka “Superbug”

Published online January 7, 2005. http://image.thelancet.com/extras/04cmt422web.pdf Isolation of patients in single rooms or cohorts to reduce spread of MRSA in intensive-care units: prospective two centre studyMoving MRSA-positive patients into single rooms or cohorted bays does not reduce crossinfection. Because transfer and isolation of critically ill patients in single rooms carries potential risks, our findings suggest that re-evaluation of isolation policies is required in intensive-care units where MRSA is endemic, and that more effective means of preventing spread of MRSA in such settings need to be found. Published online January 7, 2005 http://image.thelancet.com/extras/04art9304web.pdf Full-Text PDF