Methicillin-Resistant Staphylococcus aureus in a Canadian Intensive Care Unit: Delays in Initiating Effective Therapy Due to the Low Prevalence of InfectionReportar como inadecuado




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Canadian Journal of Infectious Diseases and Medical Microbiology - Volume 18 2007, Issue 2, Pages 139-143

Original Article

Division of Infectious Diseases, University of Alberta, Canada

Division of Critical Care, University of Alberta, Canada

Division of Medical Microbiology, University of Alberta Hospital Provincial Laboratory, Edmonton, Alberta, Canada

University of Alberta Hospital Provincial Laboratory, Edmonton, Alberta, Canada

Received 16 October 2006; Accepted 18 January 2007

Copyright © 2007 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

INTRODUCTION: Methicillin-resistant Staphylococcus aureus MRSA infection in intensive care units ICUs has increased dramatically in prevalence in recent years, and is associated with increased morbidity, mortality and cost of care. The aim of the present study was to describe the epidemiology and outcomes of MRSA infection in the general systems ICU at the University of Alberta Hospital in Edmonton, Alberta.

METHODS: A retrospective cohort analysis of patients infected with MRSA in a general systems ICU was conducted from January 1, 1997, to August 15, 2005.

RESULTS: Forty-six cases of MRSA were identified, of which 36 78.3% were infected. The most common admitting diagnoses included respiratory failure 41.7% and sepsis or septic shock 36.1%. Infection was hospital acquired in 58.3% of cases 10 cases ICU acquired, with a median time to infection of 11 days. The most common sites of infection were the respiratory tract, skin and blood. Median lengths of stay were 13 days in the unit and 27 days in-hospital. Crude mortality was 55.6%. Time to appropriate antimicrobial treatment was delayed in 80.5% of patients. Four prototypical Canadian MRSA CMRSA strains were identified by pulsed-field gel electrophoresis. Hospital-acquired strains were predominantly CMRSA-2 59%, indicating that this clone circulates at the University of Alberta Hospital.

CONCLUSIONS: MRSA infection remains uncommon at the University of Alberta Hospital, resulting in delays in instituting appropriate antimicrobial therapy. To date, only a few community-acquired strains have been noted. ICU acquisition of MRSA remains rare, with only 10 cases over the past nine years. The majority of hospital-acquired strains were CMRSA-2.





Autor: Wendy Sligl, Geoffrey Taylor, RT Noel Gibney, Robert Rennie, and Linda Chui

Fuente: https://www.hindawi.com/



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