Case-case-control study of risk factors for nasopharyngeal colonization with methicillin-resistant Staphylococcus aureus in a medical-surgical intensive care unit
Braz. j. infect. dis
;
13(6): 398-402, Dec. 2009. tab
Article
in English
| LILACS
| ID: lil-546006
ABSTRACT
Nasopharyngeal colonization with methicillin-resistant Staphylococcus aureus (MRSA) often precedes the development of nosocomial infections. In order to identify risk factors for MRSA colonization, we conducted a case-case-control study, enrolling 122 patients admitted to a medical-surgical intensive care unit (ICU). All patients had been screened for nasopharyngeal colonization with S. aureus upon admission and weekly thereafter. Two case-control studies were performed, using as cases patients who acquired colonization with MRSA and methicillin-susceptible S. aureus (MSSA), respectively. For both studies, patients in whom colonization was not detected during ICU stay were selected as control subjects. Several potential risk factors were assessed in univariate and multivariable (logistic regression) analysis. MRSA and MSSA were recovered from nasopharyngeal samples from 27 and 10 patients, respectively. Independent risk factors for MRSA colonization were length-of-stay in the ICU (Odds Ratio [OR]=1.12, 95 percentConfidence Interval[CI]=1.06-1.19, p<0.001) and use of ciprofloxacin (OR=5.05, 95 percentCI=1.38-21.90, p=0.015). The use of levofloxacin had a protective effect (OR=0.08, 95 percentCI=0.01-0.55, p=0.01). Colonization with MSSA was positively associated with central nervous system disease (OR=7.45, 95 percentCI=1.33-41.74, p=0.02) and negatively associated with age (OR=0.94, 95 percentCI=0.90-0.99, p=0.01). In conclusion, our study suggests a role for both cross-transmission and selective pressure of antimicrobials in the spread of MRSA.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Staphylococcal Infections
/
Nasopharynx
/
Methicillin-Resistant Staphylococcus aureus
/
Intensive Care Units
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Braz. j. infect. dis
Journal subject:
Communicable Diseases
Year:
2009
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade Estadual Paulista/BR
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