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2011, Number 1

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Enf Infec Microbiol 2011; 31 (1)

Outbreak of VAP for methicillin-resistant Staphylococcus aureus (MRSA) in the Adult Intensive Care Unit (AICU)

Ángeles GU, Zacate PY, López HJR, Hernández SEA, Jarill QMD, Alcantar CMD

Language: Spanish
References: 25
Page: 17-25
PDF size: 227.87 Kb.


ABSTRACT

Patients with mechanical ventilation, frequently develop ventilator-associated pneumonia (VAP) due to bronchial secretions stasis and microorganisms overgrowth.
Objective. To describe an outbreak of VAP for methicillin-resistant Staphylococcus aureus (MRSA) in the Adult Intensive Care Unit (AICU).
Design. Transversal analytical study, from January to June 2009, at the Hospital de Especialidades La Raza.
Patients and methods. We included cases of nosocomial pneumonia (NP) identified by the surveillance system of infections during the study period. A sample of bronchial secretions was taken to determine the possible etiology. General data were collected (diagnosis, age, immunological status, chemotherapy, in AICU, surgery, use of probes and antibiotics). The analysis was made with frequencies χ2, multiple regression and odds ratio (OR) with interval confidence at 95% (IC95%).
Results. We identified 197 NP, 112 VAP, and 85 non VAP (HP). Staphylococcus aureus (S. aureus) was isolated from 17 bronchial secretion samples of VAP (15.2%) and 3 (3.5%) of HP (p = 0.006). In AICU, 11 VAP (64.7%) were due to S. aureus (p ‹0001). Factors associated with VAP of S. aureus were: being hospitalized in AICU, ventilator use and tracheostomy (p ‹0.05). From 6 cultures analyzed, 5 (83.3%) had similar antimicrobial susceptibility patterns and were oxacillin resistant. Electrophoresis concluded as a single clone of these 5 strains.
Conclusions. It was not possible to demonstrate a common source. Streptococcus spp and Aerococus were isolated from glutaraldehyde, used for disinfection of ventilator tubes. Other possible sources of infection were ruled out.


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