Methicillin-resistant Staphylococcus aureus infections in ICU patients

The incidence of MRSA infections in ICU patients is growing at an alarming rate, with an associated increase in morbidity and mortality, and the costs of caring for these patients. The antibiotic choices that are currently available for treating patients with MRSA infections are both limited and expensive, and there is growing evidence of resistance by S aureus to both vancomycin and dalfopristin-quinopristin. Although widespread inappropriate antibiotic use has contributed to the growing emergence of MRSA in the ICU and elsewhere, horizontal transmission remains the primary mechanism by which patients become colonized or infected with MRSA. The increasing number of MRSA-positive patients being admitted to the ICU, together with frequent contact with these patients by ICU staff and visitors alike, has contributed to the disproportional increase in the incidence of MRSA in the ICU compared with other inpatient areas of the hospital. Prevention control measures including surveillance culturing of all ICU patients, rigorous handwashing practices, contact isolation precautions, and rational antibiotic use are the best methods for reducing the spread of MRSA in the ICU.