Methicillin-resistant Staphylococcus species in a cardiac surgical intensive care unit: A 5-year experience

Alberto Zangrillo, Giovanni Landoni, Luca Fumagalli, Tiziana Bove, Ferdinando Bellotti, Ornella Sottocorna, Andrea Roberti, Giovanni Marino

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objectives: Methicillin-resistant Staphylococcus is a growing problem in intensive care units (ICUs). The aim of this study was to describe the epidemiology of methicillin-resistant Staphylococcus isolates in a cardiac surgical ICU over a 5-year period and to determine the risk factors and outcome of this condition. Methods: During the period from January 1998 to July 2003, the clinical data of all adult patients who underwent cardiac surgery in a university hospital were prospectively recorded in a database; the perioperative clinical variables and microbiologic data were studied by means of univariate and multivariate analysis in order to identify risk factors for the development of methicillin resistance and in-hospital death. Results: Methicillin-resistant Staphylococcus species strains were isolated in 118 of 6,423 patients operated on during the study period (7.6 cases per 1,000 days of ICU stay), with a constant prevalence rate throughout the years. Methicillin-resistant Staphylococcus species have been the most frequently isolated microorganisms in the authors' ICU; 75% of Staphylococcus aureus and 95% of coagulase-negative staphylococci were methicillin resistant. In-hospital mortality in methicillin-resistant Staphylococcus-positive patients was 50.0% (59/118), whereas it was 1.7% (108/6305) in other patients (p <0.0001). On multivariate analysis, methicillin-resistant Staphylococcus species isolation was the single risk factor with the strongest association with in-hospital death (odds ratio, 8.5; 95% confidence interval 4.9-14.7). In the present series, there were no isolates of vancomycin-resistant species (Enterococcus species or Staphylococcus species). Conclusions: Staphylococcus species represent the most frequently isolated microorganisms in the authors' ICU. In-hospital mortality in cardiac surgical patients is strongly correlated to the isolation of methicillin-resistant Staphylococcus.

Original languageEnglish
Pages (from-to)31-37
Number of pages7
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume20
Issue number1
DOIs
Publication statusPublished - Feb 2006

Fingerprint

Methicillin Resistance
Critical Care
Staphylococcus
Intensive Care Units
Hospital Mortality
Multivariate Analysis
Coagulase
Thoracic Surgery
Staphylococcus aureus
Epidemiology
Odds Ratio
Databases
Confidence Intervals

Keywords

  • Cardiac surgery
  • Methicillin-resistant Staphylococcus
  • Postoperative infections

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Methicillin-resistant Staphylococcus species in a cardiac surgical intensive care unit : A 5-year experience. / Zangrillo, Alberto; Landoni, Giovanni; Fumagalli, Luca; Bove, Tiziana; Bellotti, Ferdinando; Sottocorna, Ornella; Roberti, Andrea; Marino, Giovanni.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 20, No. 1, 02.2006, p. 31-37.

Research output: Contribution to journalArticle

Zangrillo, Alberto ; Landoni, Giovanni ; Fumagalli, Luca ; Bove, Tiziana ; Bellotti, Ferdinando ; Sottocorna, Ornella ; Roberti, Andrea ; Marino, Giovanni. / Methicillin-resistant Staphylococcus species in a cardiac surgical intensive care unit : A 5-year experience. In: Journal of Cardiothoracic and Vascular Anesthesia. 2006 ; Vol. 20, No. 1. pp. 31-37.
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AU - Zangrillo, Alberto

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AU - Bove, Tiziana

AU - Bellotti, Ferdinando

AU - Sottocorna, Ornella

AU - Roberti, Andrea

AU - Marino, Giovanni

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N2 - Objectives: Methicillin-resistant Staphylococcus is a growing problem in intensive care units (ICUs). The aim of this study was to describe the epidemiology of methicillin-resistant Staphylococcus isolates in a cardiac surgical ICU over a 5-year period and to determine the risk factors and outcome of this condition. Methods: During the period from January 1998 to July 2003, the clinical data of all adult patients who underwent cardiac surgery in a university hospital were prospectively recorded in a database; the perioperative clinical variables and microbiologic data were studied by means of univariate and multivariate analysis in order to identify risk factors for the development of methicillin resistance and in-hospital death. Results: Methicillin-resistant Staphylococcus species strains were isolated in 118 of 6,423 patients operated on during the study period (7.6 cases per 1,000 days of ICU stay), with a constant prevalence rate throughout the years. Methicillin-resistant Staphylococcus species have been the most frequently isolated microorganisms in the authors' ICU; 75% of Staphylococcus aureus and 95% of coagulase-negative staphylococci were methicillin resistant. In-hospital mortality in methicillin-resistant Staphylococcus-positive patients was 50.0% (59/118), whereas it was 1.7% (108/6305) in other patients (p <0.0001). On multivariate analysis, methicillin-resistant Staphylococcus species isolation was the single risk factor with the strongest association with in-hospital death (odds ratio, 8.5; 95% confidence interval 4.9-14.7). In the present series, there were no isolates of vancomycin-resistant species (Enterococcus species or Staphylococcus species). Conclusions: Staphylococcus species represent the most frequently isolated microorganisms in the authors' ICU. In-hospital mortality in cardiac surgical patients is strongly correlated to the isolation of methicillin-resistant Staphylococcus.

AB - Objectives: Methicillin-resistant Staphylococcus is a growing problem in intensive care units (ICUs). The aim of this study was to describe the epidemiology of methicillin-resistant Staphylococcus isolates in a cardiac surgical ICU over a 5-year period and to determine the risk factors and outcome of this condition. Methods: During the period from January 1998 to July 2003, the clinical data of all adult patients who underwent cardiac surgery in a university hospital were prospectively recorded in a database; the perioperative clinical variables and microbiologic data were studied by means of univariate and multivariate analysis in order to identify risk factors for the development of methicillin resistance and in-hospital death. Results: Methicillin-resistant Staphylococcus species strains were isolated in 118 of 6,423 patients operated on during the study period (7.6 cases per 1,000 days of ICU stay), with a constant prevalence rate throughout the years. Methicillin-resistant Staphylococcus species have been the most frequently isolated microorganisms in the authors' ICU; 75% of Staphylococcus aureus and 95% of coagulase-negative staphylococci were methicillin resistant. In-hospital mortality in methicillin-resistant Staphylococcus-positive patients was 50.0% (59/118), whereas it was 1.7% (108/6305) in other patients (p <0.0001). On multivariate analysis, methicillin-resistant Staphylococcus species isolation was the single risk factor with the strongest association with in-hospital death (odds ratio, 8.5; 95% confidence interval 4.9-14.7). In the present series, there were no isolates of vancomycin-resistant species (Enterococcus species or Staphylococcus species). Conclusions: Staphylococcus species represent the most frequently isolated microorganisms in the authors' ICU. In-hospital mortality in cardiac surgical patients is strongly correlated to the isolation of methicillin-resistant Staphylococcus.

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KW - Methicillin-resistant Staphylococcus

KW - Postoperative infections

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