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Nahra R, Darvish S, Gandhi S, Gould S, Floyd D, Devine K, Fraimow H, Dibato JE, Rachoin JS. Impact of Povidone Application to Nares in Addition to Chlorhexidine Bath in Critically Ill Patients on Nosocomial Bacteremia and Central Line Blood Stream Infection. J Clin Med 2024; 13:2647. [PMID: 38731176 PMCID: PMC11084507 DOI: 10.3390/jcm13092647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/02/2024] [Accepted: 04/18/2024] [Indexed: 05/13/2024] Open
Abstract
Nosocomial Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia results in a significant increase in morbidity and mortality in hospitalized patients. We aimed to analyze the impact of applying 10% povidone iodine (PI) twice daily to both nares in addition to chlorhexidine (CHG) bathing on nosocomial (MRSA) bacteremia in critically ill patients. A quality improvement study was completed with pre and post-design. The study period was from January 2018 until February 2020 and February 2021 and June 2021. The control period (from January 2018 to May 2019) consisted of CHG bathing alone, and in the intervention period, we added 10% PI to the nares of critically ill patients. Our primary outcome is rates of nosocomial MRSA bacteremia, and our secondary outcome is central line associated blood stream infection (CLABSI) and potential cost savings. There were no significant differences in rates of MRSA bacteremia in critically ill patients. Nosocomial MRSA bacteremia was significantly lower during the intervention period on medical/surgical areas (MSA). CLABSIs were significantly lower during the intervention period in critically ill patients. There were no Staphylococcus aureus CLABSIs in critical care area (CCA)during the intervention period. The intervention showed potential significant cost savings. The application of 10% povidone iodine twice a day in addition to CHG bathing resulted in a significant decrease in CLABSIs in critically ill patients and a reduction in nosocomial MRSA in the non-intervention areas. Further trials are needed to tease out individual patients who will benefit from the intervention.
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Affiliation(s)
- Raquel Nahra
- Division of Infectious Diseases, Department of Medicine, Cooper University Healthcare, Camden, NJ 08103, USA;
- Division of Critical Care Medicine, Department of Medicine, Cooper University Healthcare, Camden, NJ 08103, USA
- Cooper Medical School of Rowan University, Camden, NJ 08103, USA; (S.G.)
- Department of Infection Prevention, Cooper University Healthcare, Camden, NJ 08103, USA;
| | - Shahrzad Darvish
- Department of Infection Prevention, Cooper University Healthcare, Camden, NJ 08103, USA;
| | - Snehal Gandhi
- Cooper Medical School of Rowan University, Camden, NJ 08103, USA; (S.G.)
- Division of Hospital Medicine, Department of Medicine, Cooper University Healthcare, Camden, NJ 08103, USA
| | | | - Diane Floyd
- Department of Nursing, Cooper University Healthcare, Camden, NJ 08103, USA
| | - Kathy Devine
- Department of Nursing, Cooper University Healthcare, Camden, NJ 08103, USA
| | - Henry Fraimow
- Division of Infectious Diseases, Department of Medicine, Cooper University Healthcare, Camden, NJ 08103, USA;
- Cooper Medical School of Rowan University, Camden, NJ 08103, USA; (S.G.)
| | - John E. Dibato
- Cooper Medical School of Rowan University, Camden, NJ 08103, USA; (S.G.)
- Cooper University Healthcare, Camden, NJ 08103, USA
| | - Jean-Sebastien Rachoin
- Division of Critical Care Medicine, Department of Medicine, Cooper University Healthcare, Camden, NJ 08103, USA
- Cooper Medical School of Rowan University, Camden, NJ 08103, USA; (S.G.)
- Division of Hospital Medicine, Department of Medicine, Cooper University Healthcare, Camden, NJ 08103, USA
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Gu F, He W, Zhu D, Yang P, Sun J, Han L. A 10-year retrospective study of methicillin-resistant Staphylococcus aureus from burn wound infection in southeast China from 2013 to 2022. Front Microbiol 2023; 14:1301744. [PMID: 38107851 PMCID: PMC10722408 DOI: 10.3389/fmicb.2023.1301744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/13/2023] [Indexed: 12/19/2023] Open
Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most commonly encountered pathogens among burn patients incurring substantial morbidity and mortality. To investigate the epidemiology and features of MRSA in burn wound infections, we conducted a 10-year retrospective study on MRSA isolated from burn patients with burn wound infections from southeast China from 2013 to 2022. Methods One hundred MRSA isolates (10 isolates each year) from burn wound infection among burn patients from 2013 to 2022 were randomly selected and enrolled. In addition to the clinical data of the 100 burn patients, MRSA isolates were characterized by antimicrobial susceptibility testing, detection of toxin genes, and molecular typing. Results The median time from the onset of burns and admission to MRSA detected was 13 and 5 days, respectively. No MRSA isolate was found resistant to quinupristin/dalfopristin, linezolid, and vancomycin. Toxin gene seg was found most frequently (90%) followed by sea (70%) and eta (64%). CC8 (74%), ST239 (70%), and SCCmec III (72%) were the most common CC, ST, and SCCmec types, respectively. Conclusion ST239-III (70%) was the predominant clone found in MRSA from burn wound infection among burn patients in southeast China. ST239-III was less found from 2018 to 2022. A higher diversity of MRSA clones was observed in these recent 5 years than that from 2013 to 2017.
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Affiliation(s)
- Feifei Gu
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiping He
- Department of Clinical Laboratory, Huaihe Hospital of Henan University, Kaifeng, Henan, China
| | - Dedong Zhu
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Peilang Yang
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingyong Sun
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lizhong Han
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Popovich KJ, Aureden K, Ham DC, Harris AD, Hessels AJ, Huang SS, Maragakis LL, Milstone AM, Moody J, Yokoe D, Calfee DP. SHEA/IDSA/APIC Practice Recommendation: Strategies to prevent methicillin-resistant Staphylococcus aureus transmission and infection in acute-care hospitals: 2022 Update. Infect Control Hosp Epidemiol 2023; 44:1039-1067. [PMID: 37381690 PMCID: PMC10369222 DOI: 10.1017/ice.2023.102] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 05/03/2023] [Indexed: 06/29/2023]
Abstract
Previously published guidelines have provided comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute-care hospitals in implementing and prioritizing efforts to prevent methicillin-resistant Staphylococcus aureus (MRSA) transmission and infection. This document updates the "Strategies to Prevent Methicillin-Resistant Staphylococcus aureus Transmission and Infection in Acute Care Hospitals" published in 2014.1 This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA). It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise.
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Affiliation(s)
- Kyle J. Popovich
- Department of Internal Medicine, RUSH Medical College, Chicago, Illinois
| | - Kathy Aureden
- Infection Prevention, Advocate Aurora Health, Downers Grove, Illinois
| | - D. Cal Ham
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anthony D. Harris
- Health Care Outcomes Research, University of Maryland School of Medicine, Baltimore, Maryland
| | - Amanda J. Hessels
- Columbia School of Nursing, New York, New York
- Hackensack Meridian Health, Edison, New Jersey
| | - Susan S. Huang
- Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California
| | - Lisa L. Maragakis
- Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Aaron M. Milstone
- Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Julia Moody
- Infection Prevention, HCA Healthcare, Nashville, Tennessee
| | - Deborah Yokoe
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California
- Transplant Infectious Diseases, UCSF Medical Center, San Francisco, California
| | - David P. Calfee
- Department of Medicine, Weill Cornell Medicine, New York, New York
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
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Stone MJ, Swales C, Bond S, Muthayya P, Sarma JB. An outbreak of livestock-associated meticillin-resistant Staphylococcus aureus (LA-MRSA) clonal complex 398 in a Regional Burns Centre. J Hosp Infect 2021; 122:1-8. [PMID: 34902497 DOI: 10.1016/j.jhin.2021.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND MRSA outbreaks have previously been reported in burns centres with resulting mortality and morbidity. We describe the first human associated outbreak in the UK caused by a strain of mupirocin-resistant (MuR) livestock-associated meticillin-resistant Staphylococcus aureus clonal complex 398 (LA-MRSA CC398) in an Adult Burns Centre. The centre historically had a very low prevalence of MRSA infections. AIM This report describes the clinical and epidemiological context of how the outbreak was identified and contained using a range of infection prevention and control (IPC) measures guided by both traditional and genetic methods. METHODS A cluster of MuR-MRSA led to an outbreak investigation. Cases were detected via retrospective search and real-time laboratory surveillance. Isolates were sent continuously for whole genome sequencing (WGS). A live timeline of cases and interventions was produced throughout the period. FINDINGS The outbreak consisted of twelve cases, seven males and five females, aged between 22 to 70 years. Patients were identified between May and October 2020. All patients were colonized rather than infected. The strain acquired the plasmid bearing MupA while colonizing the index case before dissemination. The index case was found to be a chicken farmer. This outbreak was eventually controlled using IPC measures, audits and blind staff decolonization guided by the insight from WGS. CONCLUSION We could not determine how the strain entered the centre or if a staff carrier was involved. The outbreak demonstrated the potential for continued transmissions for months despite active surveillance and stringent control measures.
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Affiliation(s)
- Matthew James Stone
- Department of Burns and Plastic Surgery, The Mid Yorkshire Hospitals NHS Trust, UK
| | - Claire Swales
- Department of Burns and Plastic Surgery, The Mid Yorkshire Hospitals NHS Trust, UK
| | - Stuart Bond
- Pharmacy Department, The Mid Yorkshire Hospitals NHS Trust, UK
| | - Preetha Muthayya
- Department of Burns and Plastic Surgery, The Mid Yorkshire Hospitals NHS Trust, UK
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Hill DM, Boyd AN, Zavala S, Adams B, Reger M, Maynard KM, Adams TR, Drabick Z, Carter K, Johnson HA, Alexander KM, Smith L, Frye J, Gayed RM, Quan AN, Walroth TA. A review of the most impactful published pharmacotherapy-pertinent literature of 2019 and 2020 for clinicians caring for patients with thermal or inhalation injury. J Burn Care Res 2021; 43:912-920. [PMID: 34788823 DOI: 10.1093/jbcr/irab220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Keeping abreast with current literature can be challenging, especially for practitioners caring for patients sustaining thermal or inhalation injury. Practitioners caring for patients with thermal injuries publish in a wide variety of journals, which further increases the complexity for those with resource limitations. Pharmacotherapy research continues to be a minority focus in primary literature. This review is a renewal of previous years' work to facilitate extraction and review of the most recent pharmacotherapy-centric studies in patients with thermal and inhalation injury. Sixteen geographically dispersed, board-certified pharmacists participated in the review. A MeSH-based, filtered search returned 1,536 manuscripts over the previous 2-year period. After manual review and exclusions, only 98 (6.4%) manuscripts were determined to have a potential impact on current pharmacotherapy practices and included in the review. A summary of the 10 articles that scored highest are included in the review. Nearly half of the reviewed manuscripts were assessed to lack a significant impact on current practice. Despite an increase in published literature over the previous 2-year review, the focus and quality remain unchanged. There remains a need for investment in well-designed, high impact, pharmacotherapy-pertinent research for patients sustaining thermal or inhalation injuries.
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Affiliation(s)
- David M Hill
- Department of Pharmacy, Regional One Health, Memphis, TN
| | - Allison N Boyd
- Department of Pharmacy, Eskenazi Health, Indianapolis, IN
| | - Sarah Zavala
- Department of Pharmacy, Community Hospital, Munster, IN
| | - Beatrice Adams
- Department of Pharmacy, Tampa General Hospital, Tampa, FL
| | - Melissa Reger
- Department of Pharmacy, Community Regional Medical Center, Fresno, CA
| | - Kaylee M Maynard
- Department of Pharmacy, University of Rochester Medical Center, Rochester, NY
| | - Tori R Adams
- Department of Pharmaceutical Care, University of Iowa Health Care, Iowa City, IA
| | - Zachary Drabick
- Department of Pharmacy, University of Florida Health Shands Hospital, Gainesville, FL
| | - Kristen Carter
- Department of Pharmacy, UC Health University of Cincinnati Medical Center, Cincinnati, OH
| | - Heather A Johnson
- Department of Pharmacy, Methodist Hospital and Methodist Children's Hospital, San Antonio, TX
| | - Kaitlin M Alexander
- Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, FL
| | - Lisa Smith
- Department of Pharmacy, Doctors Hospital, Augusta, GA
| | - Jared Frye
- Department of Pharmaceutical Care, University of Iowa Health Care, Iowa City, IA
| | - Rita M Gayed
- Department of Pharmacy and Clinical Nutrition, Grady Health System, Atlanta, GA
| | - Asia N Quan
- Department of Pharmacy, The Arizona Burn Center Valleywise Health, Phoenix, AZ
| | - Todd A Walroth
- Department of Pharmacy, Eskenazi Health, Indianapolis, IN
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Coia JE, Wilson JA, Bak A, Marsden GL, Shimonovich M, Loveday HP, Humphreys H, Wigglesworth N, Demirjian A, Brooks J, Butcher L, Price JR, Ritchie L, Newsholme W, Enoch DA, Bostock J, Cann M, Wilson APR. Joint Healthcare Infection Society (HIS) and Infection Prevention Society (IPS) guidelines for the prevention and control of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities. J Hosp Infect 2021; 118S:S1-S39. [PMID: 34757174 DOI: 10.1016/j.jhin.2021.09.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/03/2021] [Accepted: 09/13/2021] [Indexed: 12/28/2022]
Affiliation(s)
- J E Coia
- Department of Clinical Microbiology, Hospital South West Jutland, Esbjerg, Denmark; Department of Regional Health Research IRS, University of Southern Denmark, Denmark; Healthcare Infection Society, London, UK
| | - J A Wilson
- Richard Wells Research Centre, University of West London, London, UK; Infection Prevention Society, Seafield, UK
| | - A Bak
- Healthcare Infection Society, London, UK.
| | | | - M Shimonovich
- Healthcare Infection Society, London, UK; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - H P Loveday
- Richard Wells Research Centre, University of West London, London, UK; Infection Prevention Society, Seafield, UK
| | - H Humphreys
- Healthcare Infection Society, London, UK; Department of Clinical Microbiology, The Royal College of Surgeons, Ireland; Department of Microbiology, Beaumont Hospital, Dublin, Ireland
| | - N Wigglesworth
- Infection Prevention Society, Seafield, UK; East Kent Hospitals University, NHS Foundation Trust, Canterbury, UK
| | - A Demirjian
- Healthcare-associated Infection and Antimicrobial Resistance, Public Health England, London, UK; Paediatric Infectious Diseases and Immunology, Evelina London Children's Hospital, London, UK; Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - J Brooks
- Infection Prevention Society, Seafield, UK; University Hospital Southampton NHS Foundation Trust, UK
| | - L Butcher
- Infection Prevention Society, Seafield, UK; Oxford University Hospitals NHS Foundation Trust, UK
| | - J R Price
- Healthcare Infection Society, London, UK; Imperial College Healthcare NHS Trust, London, UK
| | - L Ritchie
- Healthcare Infection Society, London, UK; NHS England and NHS Improvement, London, UK
| | - W Newsholme
- Healthcare Infection Society, London, UK; Guy's and St Thomas' NHS Foundation Trust, UK
| | - D A Enoch
- Healthcare Infection Society, London, UK; Clinical Microbiology & Public Health Laboratory, Public Health England, Addenbrooke's Hospital, Cambridge, UK
| | | | - M Cann
- Lay Member, UK; MRSA Action UK, Preston, UK
| | - A P R Wilson
- Healthcare Infection Society, London, UK; University College London Hospitals NHS Foundation Trust, UK.
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Gregory TV, Ellis K, Valeriani R, Khan F, Wu X, Murin L, Alibayov B, Vidal AGJ, Zhao T, Vidal JE. MoWa: A Disinfectant for Hospital Surfaces Contaminated With Methicillin-Resistant Staphylococcus aureus (MRSA) and Other Nosocomial Pathogens. Front Cell Infect Microbiol 2021; 11:676638. [PMID: 34295834 PMCID: PMC8291128 DOI: 10.3389/fcimb.2021.676638] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/13/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Staphylococcus aureus strains, including methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA), are a main cause of nosocomial infection in the world. The majority of nosocomial S. aureus-infection are traced back to a source of contaminated surfaces including surgery tables. We assessed the efficacy of a mixture of levulinic acid (LA) and sodium dodecyl sulfate (SDS), hereafter called MoWa, to eradicate nosocomial pathogens from contaminated surfaces. Methods and Results A dose response study demonstrated that MoWa killed 24 h planktonic cultures of S. aureus strains starting at a concentration of (LA) 8.2/(SDS) 0.3 mM while 24 h preformed biofilms were eradicated with 32/1.3 mM. A time course study further showed that attached MRSA bacteria were eradicated within 4 h of incubation with 65/2 mM MoWa. Staphylococci were killed as confirmed by bacterial counts, and fluorescence micrographs that were stained with the live/dead bacterial assay. We then simulated contamination of hospital surfaces by inoculating bacteria on a surface prone to contamination. Once dried, contaminated surfaces were sprayed with MoWa or mock-treated, and treated contaminated surfaces were swabbed and bacteria counted. While bacteria in the mock-treated samples grew at a density of ~104 cfu/cm2, those treated for ~1 min with MoWa (1.0/0.04 M) had been eradicated below limit of detection. A similar eradication efficacy was obtained when surfaces were contaminated with other nosocomial pathogens, such as Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, or Staphylococcus epidermidis. Conclusions MoWa kills planktonic and biofilms made by MRSA and MSSA strains and showed great efficacy to disinfect MRSA-, and MSSA-contaminated, surfaces and surfaces contaminated with other important nosocomial pathogens.
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Affiliation(s)
- Tyler V. Gregory
- Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, MS, United States
- Biomedical Sciences Master of Science Program, University of Mississippi Medical Center, Jackson, MS, United States
| | - Karen Ellis
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Renzo Valeriani
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Faidad Khan
- Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Xueqing Wu
- Department of Infectious Disease, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Landon Murin
- Base Pair Program Murrah- University of Mississippi Medical Center, Jackson, MS, United States
| | - Babek Alibayov
- Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Ana G. Jop Vidal
- Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Tong Zhao
- Center for Food Safety, University of Georgia, Griffin, GA, United States
| | - Jorge E. Vidal
- Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, MS, United States
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Meneguin S, Torres EA, Pollo CF. Fatores associados à infecção por Staphylococcus aureus resistente à meticilina em unidade de terapia intensiva. Rev Bras Enferm 2020; 73:e20190483. [PMID: 32901736 DOI: 10.1590/0034-7167-2019-0483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/18/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify factors associated with methicillin-resistant Staphylococcus aureus (MRSA) infection in adult patients admitted to the Intensive Care Unit (ICU), and to compare them with a control group. METHODS Retrospective case-control study carried out in an adult ICU, from January 2015 to June 2017, with 61 patients who developed methicillin-resistant Staphylococcus aureus infection and the same number of control patients. RESULTS Most participants were male 65 (60.6%), with a neurological diagnosis 43 (35.2%) and hypertensive 61 (50.0%). In the comparison of the groups, there was a statistically significant difference in relation to mechanical ventilation (p=0.0107), tracheostomy (p=0.0083), death (p=0.0401), urinary catheter (p=0.0420), length of stay (p<0.0001) and severity (p=0.0003). The main factors associated with methicillin-resistant Staphylococcus aureus infection were: severity (OR= 65.69; CI=3.726-4.808; p=0.0018), use of antimicrobials (OR= 0.047;CI=0.028-0.122;p=0.0024), length of stay (OR=1.19; CI=0.952-1.031; p=0.0285). CONCLUSION methicillin-resistant Staphylococcus aureus infection is multifactorial and has been associated with length of stay and severity. Use of antimicrobials was a protective factor.
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Affiliation(s)
- Silmara Meneguin
- Universidade Estadual Paulista Julio de Mesquita Filho. Botucatu, São Paulo, Brazil
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Robben PM, Ayalew MD, Chung KK, Ressner RA. Multi-Drug-Resistant Organisms in Burn Infections. Surg Infect (Larchmt) 2020; 22:103-112. [PMID: 32429798 DOI: 10.1089/sur.2020.129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: Infection is the most frequent complication after severe burns and remains the predominant cause of death. Burn patients may require multiple courses of antibiotics, lengthy hospitalizations, and invasive procedures that place burn patients at especially high risk for infections with multi-drug-resistant organisms (MDROs). Methods: The published literature on MDROs in burn patients was reviewed to develop a strategy for managing these infections. Results: Within a burn unit meticulous infection prevention and control measures and effective antimicrobial stewardship can limit MDRO propagation and decrease the antibiotic pressure driving the selection of MDROs from less resistant strains. Several new antimicrobial agents have been developed offering potential therapeutic options, but familiarity with their benefits and limitations is required for safe utilization. Successful management of MDRO burn infections is supported by a multifactorial approach. Novel non-antibiotic therapeutics may help combat MDRO infections and outbreaks. Conclusions: Multi-drug-resistant organisms are being identified with increasing frequency in burn patients. Effective sensitivity testing is essential to identify MDROs and to direct appropriate antibiotic choices for patient treatment.
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Affiliation(s)
- Paul M Robben
- Infectious Diseases Service, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.,The Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Memar D Ayalew
- Infectious Diseases Service, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Kevin K Chung
- The Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Roseanne A Ressner
- Infectious Diseases Service, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.,The Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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