The use of a critical care consult team to identify risk for methicillin-resistant Staphylococcus aureus infection and the potential for early intervention

A pilot study

Adam B. Keene, Luciano Lemos-Filho, Michael H. Levi, Jose Gomez-Marquez, Jose Yunen, Hayder Said, Franklin D. Lowy

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

OBJECTIVE: To test whether a critical care consult team can be used to identify patients who have methicillin-resistant Staphylococcus aureus nasal colonization during a window period at which they are at highest risk for methicillin-resistant S. aureus infection and can most benefit from topical decolonization strategies. DESIGN: Prospective cohort study. SETTING: Two adult tertiary care hospitals. PATIENTS: Patients with at least one risk factor for methicillin-resistant S. aureus nasal colonization who were seen by a critical care consult team for potential intensive care unit admission were enrolled. INTERVENTIONS: Nasal cultures for methicillin-resistant S. aureus were performed on all subjects. All subjects were followed for the development of a methicillin-resistant S. aureus infection for 60 days or until hospital discharge. Demographic and outcome data were recorded on all subjects. MEASUREMENTS AND MAIN RESULTS: Two hundred subjects were enrolled. Overall 29 of 200 (14.5%) were found to have methicillin-resistant S. aureus nasal colonization. Methicillin-resistant S. aureus infections occurred in seven of 29 (24.1%) subjects with methicillin-resistant S. aureus nasal colonization vs. one of 171 (0.6%) subjects without methicillin-resistant S. aureus nasal colonization (p <.001). Methicillin-resistant S. aureus clinical specimens were recovered in 15 of 29 (51.7%) subjects with methicillin-resistant S. aureus nasal colonization vs. two of 171 (1.2%) without methicillin-resistant S. aureus nasal colonization. CONCLUSIONS: A critical care consult team can be used to rapidly recognize patients with methicillin-resistant S. aureus nasal colonization who are at very elevated risk for methicillin-resistant S. aureus infection. The use of such a team to recognize patients who have greatest potential benefit from decolonization techniques might reduce the burden of severe methicillin-resistant S. aureus infections.

Original languageEnglish (US)
Pages (from-to)109-113
Number of pages5
JournalCritical Care Medicine
Volume38
Issue number1
DOIs
StatePublished - Jan 2010

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Critical Care
Methicillin-Resistant Staphylococcus aureus
Nose
Infection
Tertiary Healthcare
Tertiary Care Centers
Intensive Care Units
Cohort Studies

Keywords

  • Infection prevention
  • MRSA
  • Nasal colonization
  • Nosocomial infection
  • Staphylococcus aureus

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

The use of a critical care consult team to identify risk for methicillin-resistant Staphylococcus aureus infection and the potential for early intervention : A pilot study. / Keene, Adam B.; Lemos-Filho, Luciano; Levi, Michael H.; Gomez-Marquez, Jose; Yunen, Jose; Said, Hayder; Lowy, Franklin D.

In: Critical Care Medicine, Vol. 38, No. 1, 01.2010, p. 109-113.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: To test whether a critical care consult team can be used to identify patients who have methicillin-resistant Staphylococcus aureus nasal colonization during a window period at which they are at highest risk for methicillin-resistant S. aureus infection and can most benefit from topical decolonization strategies. DESIGN: Prospective cohort study. SETTING: Two adult tertiary care hospitals. PATIENTS: Patients with at least one risk factor for methicillin-resistant S. aureus nasal colonization who were seen by a critical care consult team for potential intensive care unit admission were enrolled. INTERVENTIONS: Nasal cultures for methicillin-resistant S. aureus were performed on all subjects. All subjects were followed for the development of a methicillin-resistant S. aureus infection for 60 days or until hospital discharge. Demographic and outcome data were recorded on all subjects. MEASUREMENTS AND MAIN RESULTS: Two hundred subjects were enrolled. Overall 29 of 200 (14.5{\%}) were found to have methicillin-resistant S. aureus nasal colonization. Methicillin-resistant S. aureus infections occurred in seven of 29 (24.1{\%}) subjects with methicillin-resistant S. aureus nasal colonization vs. one of 171 (0.6{\%}) subjects without methicillin-resistant S. aureus nasal colonization (p <.001). Methicillin-resistant S. aureus clinical specimens were recovered in 15 of 29 (51.7{\%}) subjects with methicillin-resistant S. aureus nasal colonization vs. two of 171 (1.2{\%}) without methicillin-resistant S. aureus nasal colonization. CONCLUSIONS: A critical care consult team can be used to rapidly recognize patients with methicillin-resistant S. aureus nasal colonization who are at very elevated risk for methicillin-resistant S. aureus infection. The use of such a team to recognize patients who have greatest potential benefit from decolonization techniques might reduce the burden of severe methicillin-resistant S. aureus infections.",
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AU - Said, Hayder

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