Methicillin Resistant Staphylococcus Aureus in Ventilator Associated Pneumonia in Toxicological Intensive Care Unit

Abstract

Background: Methicillin resistant Staphylococus Aureus (MRSA) is a cause of nosocomial infections at intensive care unit (ICU), which imposes a high mortality and morbidity on the health care systems. The objective of this study was to evaluate the role of MRSA in patients with clinically suspected ventilator associated pneumonia (VAP) in toxicological ICU admitted patients. Methods: This cross-sectional study was performed over a period of six months from August 2009 to February 2010. A total of 84 patients with clinically suspected VAP were selected from all 381 ICU admitted patients under mechanical ventilation for more than 48 hours. MRSA Screen Agar was used to detect resistance in Staph aureus specimens. MRSA was determined as the main outcome. Results: MRSA was the cause in 54% of Staph aureus infected VAPs. Although MRSA infection was not significantly associated with age, gender, cause of poisoning, chronic disease, paraclinical findings, length of hospital stay, and antibiotic prescription (P>0.05 for all comparisons), it was reported higher in those who expired than those who survived (66.7% vs. 31.9%, P<0.012). Conclusion: In the main referral toxicological ICU in Tehran, in more than 1 of 3 clinically suspected VAP cases, MRSA was seen which was associated with the poorer outcome, higher inpatient mortality