Original Article

Relationship between Nasal Colonization with Methicillin-Resistant Staphylococcus Aureus and Nosocomial Infection in Patients in the Intensive Care Unit

  • Rüçhan ULUTÜRK
  • G. Ülkü ÖZKANTAR
  • Muzaffer FİNCANCI
  • A. Cem YARDIMCI
  • Özden DESTANOĞLU

İstanbul Med J 2010;11(4):159-163

Objectives:

This study was designed to evaluate the relationship between nasal colonization with methicillinresistant Staphylococcus aureus (MRSA) and nosocomial infection in patients hospitalized in the intensive care unit (ICU) of İstanbul Education and Research Hospital.

Methods:

Nasal swabs from both cavities were taken and plated for MRSA on admission, on the fourth and the seventh days, and twice weekly thereafter (n=286). Nasal colonization with MRSA was detected in 14 (4.9%) patients (2 on admission, 8 on the fourth day, 4 on the seventh day). The colonized patients were isolated and decolonized by using nasal mupirocin twice daily for five days.

Results:

When they were recultured 48 hours after the completion of decolonization therapy, they no longer harbored nasal MRSA, but nosocomial infections were observed in two (14.3%) of the colonized patients. MRSA was isolated from blood on the seventh day from a patient who harbored nasal MRSA on the fourth day, and the other patient had MRSA in the tracheal aspirate on the tenth day.

Conclusion:

Our results indicate that the prevalence of nasal colonization with MRSA increases as the hospitalization period in the ICU is prolonged, and decolonization of the colonized patients helps to reduce the frequency of nosocomial infections, but is not sufficient for eradication.

Keywords: Methicillin-resistant Staphylococcus aureus, nasal colonization