Risk Factors for Acquisition of Methicillin-Resistant Staphylococcus aureus in a Neurosurgical Intensive Care Unit(NSICU): Case-Control Study / 기본간호학회지

ABSTRACT

PURPOSE: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen in the intensive care units (ICUs). The purpose of this case-control study is to identify risk factors for acquisition of MRSA during ICU stays in patients with and without MRSA. METHOD: The study was conducted in a 16 beds-neurosurgical intensive care unit of a 2200-bed tertiary care university hospital in Seoul, Korea. Medical record and Critical Classification Scoring System were reviewed retrospectively in patients who were admitted more than 3 days from August 1, 2003 to May 30, 2004. Cases and controls were matched for age and gender. The obtained specimens were nasal swab and sputum. RESULT: There were 950 patients' admissions during the period. Among them, MRSA was isolated from twenty-three patients who were considered as hospital acquired. Artificial airway (p=.045), frequency of suction (p=.002), nasogastric tube (p=.004), wound drain (p=.045), and vancomycin (p=.019) were risk factors for MRSA acquisition in univariate analysis. Frequency of suction (p=.012, OR 3.5) was revealed as the only risk factor in multivariate conditional logistic regression. CONCLUSION: Our findings give support to recent studies that suggest that frequent physical contact may increase the nosocomial acquisition of MRSA in a neurosurgical ICU.