Methicillin‐Resistant Staphylococcus aureus in German Intensive Care Units During 2000‐2003: Data from Project SARI (Surveillance of Antimicrobial Use and Antimicrobial Resistance in Intensive Care Units)

• Published in: Infection control and hospital epidemiology 2006-02, Vol.27 (2), p.146-154
• Main Authors: Meyer, Elisabeth, Schwab, Frank, Gastmeier, Petra, Jonas, Daniel, Rueden, Henning, Daschner, Franz D.
• Format: Article
• Language: English
• Subjects: Anti-Infective Agents - therapeutic use; Antibacterial agents; Antibiotic resistance; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimicrobials; Bacterial diseases; Biological and medical sciences; Cephalosporins; Correlation coefficients; Correlations; Cross Infection; Germany - epidemiology; Human bacterial diseases; Humans; Infections; Infectious diseases; Intensive Care Units; Medical sciences; Methicillin Resistance; Miscellaneous; Nursing; Original Article; Pharmacology. Drug treatments; Population Surveillance; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Staphylococcal Infections - epidemiology; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcus aureus; Staphylococcus aureus - drug effects; Staphylococcus aureus - isolation & purification; Statistical significance; Surveillance
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1086/500619

The objective of this study was to analyze methicillin-resistant Staphylococcus aureus (MRSA) percentages (defined as the percentage of S. aureus isolates that are resistant to methicillin) and antimicrobial consumption in intensive care units (ICUs) participating in Project SARI (Surveillance of Antimicrobial Use and Antimicrobial Resistance in Intensive Care Units), to look for temporal changes in MRSA percentages and antimicrobial consumption in individual ICUs as an indicator of the impact of an active surveillance system, and to investigate the differences between ICUs with increased MRSA percentages versus those with decreased percentages during a period of 3 years (2001-2003). This was a prospective, ICU-based and laboratory-based surveillance study involving 38 German ICUs during 2000-2003. Antimicrobial use was reported in terms of defined daily doses (DDDs) per 1,000 patient-days. Temporal changes in the MRSA percentage and antimicrobial use in individual ICUs were calculated by means of the Wilcoxon signed rank test. The incidence density of nosocomial MRSA infection was defined as the number of nosocomial MRSA infections per 1,000 patient-days. From February 2000 through December 2003, a total of 38 ICUs reported data on 499,694 patient-days and 9,552 S. aureus isolates, including 2,249 MRSA isolates and 660,029 DDDs of antimicrobials. Cumulative MRSA percentages ranged from 0% to 64.4%, with a mean of 23.6%. The MRSA incidence density ranged from 0 to 38.2 isolates per 1,000 patient-days, with a mean of 2.77 isolates per 1,000 patient-days. There was a positive correlation between MRSA percentage and imipenem and ciprofloxacin use (P