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Transmission of antibiotic-resistant bacteria linked to previous intensive care unit room occupants

Staying in a room in the intensive care unit (ICU) previously occupied by a patient with treatment-resistant bacteria may increase the odds of acquiring such bacteria, according to a report in the October 9 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Two particular microorganisms cause significant illness and death in hospitals: methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), according to background information in the article. Researchers previously found that 29 percent of patients who acquire these pathogens develop infections or other complications within 18 months. Floors, beds, gowns, faucets and other hospital room fixtures are persistently contaminated with these bacteria, but it is not known whether levels of the bacteria are high enough to infect additional patients or whether currently mandated cleaning practices are effective in reducing bacterial spread. "Although high-risk rooms may exist because of difficult-to-clean design or poor placement of hand hygiene equipment, transmission may be more directly linked to a prior occupant who harbors a resistant organism rather than to a particular room," the authors write.

Susan S. Huang, M.D., M.P.H., Brigham and Women's Hospital and Harvard Medical School, Boston, and colleagues conducted a 20-month study of 8,203 patients who had 11,528 stays in eight ICUs between 2003 and 2005. As part of the hospitals' normal protocols, cultures were obtained from all ICU patients when they arrived and every week they stayed to determine the presence of MRSA and VRE.

Upon entering the ICU, 809 patients carried MRSA and 658 carried VRE, leaving 7,629 to screen for the acquisition of MRSA and 7,806 for acquisition of VRE. The average patient age was 61 years, and 58 percent were male. Fourteen percent of these ICU patients stayed in rooms in which the prior occupant had MRSA and 13 percent stayed in rooms in which t
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Source:JAMA and Archives Journals


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