Relevanz von MRSA auf einer viszeralchirurgischen Intensivstation

Abstract

Resistance to antibiotics is a worldwide increasing problem. A well-known example is methicillin resistant Staphylococcus aureus, MRSA. What is the relevance of MRSA on a surgical ICU? On a 20 bed academic SICU/intermediate care ward 14,976 patients were treated in a seven-year period. We identified only 98 MRSA-positive patients. 56 (57 %) of them were merely colonised, 42 (43 %) suffered from an MRSA infection. A control group comprised 56 similar patients without MRSA detection. Patients with MRSA infection had a higher mortality rate (OR 4.18; p = 0.002), but only 4 out of 20 patients died due to the MRSA infection. APACHE 2 score of more than 20 was predictive for being colonised with MRSA (OR 3.08; p = 0.04), but it was not a risk factor for developing an MRSA infection (OR 1.03; p = 0.95). Patients with MRSA colonisation did not have a higher mortality rate than patients without. Outcome depended on severity of the disease, but not on the MRSA colonisation status. Patients with MRSA infection were more likely to die, but the reason of death rarely was MRSA.

Editorial

“…Das dritte Thema dieser Ausgabe des Zentralblattes stellt ein ganz wesentliches dar, nämlich die in deutschen Krankenhäusern weit verbreiteten und uns allen belastenden MRSA-Infektionen. Die Arbeit aus Freiburg von Utzolino et al [7] beleuchtet die Inzidenz und Wertigkeit von MRSA-Kolonisation und vor allem -Infektion auf einer viszeralchirurgischen Intensiv-und IMC-Station. Die Autoren kommen zu dem Schluss, dass zwar die Letalität von Patienten mit MRSA-Infektion deutlich höher ist als die von Patienten ohne.…”