Deparment of Peds, Division PICU, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Am J Emerg Med. 2013 Apr;31(4):727-9. doi: 10.1016/j.ajem.2012.12.033. Epub 2013 Feb 8.
Methicillin-resistant Staphylococcus aureus (MRSA) colonization is consistently rising. The question whether the MRSA colonization places the patients at higher risk, requiring higher levels of care when being admitted, has never been studied. We conducted this study to determine the impact of MRSA colonization status on the required level of care upon admission to hospital.
We conducted a retrospective chart review in 1000 plus-bed tertiary care academic institute. Our study population composed of all the patients who were admitted from January 2011 to March 2011. We found 7413 pediatric admissions that were identified as the study subjects. We assessed and divided study subjects into 2 groups, MRSA colonized and MRSA noncolonized. Methicillin-resistant Staphylococcus aureus-colonized patients were further grouped into those admitted to either pediatric intensive care unit (PICU) or ward, and these 2 groups were analyzed using P value, Fisher exact test, relative risks, and odds ratios.
We found a total of 7413 admissions, 753 were admitted in PICU (average pediatric risk of mortality score 18), and 6660 were admitted in pediatric wards (average pediatric risk of mortality score, 5). We found that MRSA colonization was 20 (2.66%) of 753 in PICU admissions and 155 (2.33%) of 6660 in ward admissions. We found that rate of admissions difference between MRSA colonized and MRSA noncolonized groups was clinically insignificant (P > .05).
We conclude that MRSA colonization does not increase the need of care in PICU upon admission to hospital from emergency department. However, these preliminary results need to be confirmed through larger, multicenter, and multicountry data analysis.
耐甲氧西林金黄色葡萄球菌(MRSA)定植率持续上升。MRSA 定植是否会使患者面临更高的风险,需要在入院时给予更高水平的护理,这一问题从未得到研究。我们开展此项研究旨在确定 MRSA 定植状态对入院时所需护理水平的影响。
我们在一家拥有 1000 多张床位的三级保健学术机构中进行了回顾性图表审查。我们的研究人群由 2011 年 1 月至 2011 年 3 月入院的所有患者组成。我们共发现 7413 例儿科入院患者,将其确定为研究对象。我们评估并将研究对象分为 2 组,MRSA 定植组和 MRSA 非定植组。MRSA 定植患者进一步分为入住儿科重症监护病房(PICU)或普通病房的患者,使用 P 值、Fisher 确切检验、相对风险和优势比对这 2 组进行分析。
我们共发现 7413 例入院患者,753 例入住 PICU(平均儿科病死率风险评分 18),6660 例入住儿科病房(平均儿科病死率风险评分 5)。我们发现,753 例 PICU 入院患者中有 20 例(2.66%)定植 MRSA,6660 例普通病房入院患者中有 155 例(2.33%)定植 MRSA。我们发现,MRSA 定植组和非定植组的入院率差异无统计学意义(P>0.05)。
我们得出结论,MRSA 定植不会增加从急诊科入院至 PICU 时的护理需求。然而,这些初步结果需要通过更大规模、多中心和多国数据分析来证实。