Ibelings M M, Bruining H A
Department of Surgery, University Hospital Rotterdam Dijkzigt, The Netherlands.
Eur J Surg. 1998 Jun;164(6):411-8. doi: 10.1080/110241598750004210.
To evaluate the risk of patients in intensive care units (ICU) of becoming infected with methicillin-resistant Staphylococcus aureus (MRSA) and to assess the mortality during a six week follow-up period, compared with patients who developed methicillin-sensitive S. aureus (MSSA) infection.
Point prevalence survey.
1417 ICU in 17 Western European countries.
10038 patients in ICU who were part in the EPIC (European Prevalence of Infection in Intensive Care) Study.
Prevalence of MRSA and MSSA ICU-acquired infections, risk factors, and mortality.
On the study day 21% of patients had ICU-acquired infections. The most commonly reported pathogen was Staphylococcus aureus (30%). Overall, 60% of strains of S. aureus were resistant to methicillin (with a wide intercountry variation). The most commonly reported MRSA infections were pneumonia and lower respiratory tract infections. The most important risk factor for MRSA was the length of stay in the ICU. MRSA infection reduced the chance of survival, particularly when it was found in lower respiratory tract infections: the risk of mortality was three times higher in patients with MRSA than in those with MSSA.
Patients in ICU are at high risk of becoming infected with MRSA. The longer they stay, the higher the risk. Patients with MRSA infections are less likely to survive than those with MSSA.
评估重症监护病房（ICU）患者感染耐甲氧西林金黄色葡萄球菌（MRSA）的风险，并评估在为期六周的随访期内的死亡率，与发生甲氧西林敏感金黄色葡萄球菌（MSSA）感染的患者进行比较。
现患率调查。
17个西欧国家的1417个ICU。
参与欧洲重症监护感染现患率（EPIC）研究的10038例ICU患者。
MRSA和MSSA医院获得性感染的现患率、危险因素及死亡率。
在研究当日，21%的患者发生了ICU获得性感染。最常报告的病原体是金黄色葡萄球菌（30%）。总体而言，60%的金黄色葡萄球菌菌株对甲氧西林耐药（国家间差异很大）。最常报告的MRSA感染是肺炎和下呼吸道感染。MRSA最重要的危险因素是在ICU的住院时间。MRSA感染降低了生存几率，尤其是在下呼吸道感染中发现时：MRSA感染患者的死亡风险是MSSA感染患者的三倍。
ICU患者感染MRSA的风险很高。住院时间越长，风险越高。MRSA感染患者的生存可能性低于MSSA感染患者。
