Methicillin-resistant Staphylococcos aureus and Acinetobacter baumanii mucocutaneous colonization and nosocomial infection in medical intensive care patients.

This study was designed to assess the frequency and risk factors for coloni zation with MRSA and A. baumanii in the intensive care unit, and to analyse the relationship between colonization and infection with MRSA or A. bauman ii. During a 24-day survey period, colonization was studied weekly with nas al, throat and digit skin swabs; nosocomial infections were routinely monit ored according to CDC recommendations. Clinical data and invasive procedure s were registered during a one-year non-epidemic period; 103 ICU patients h ospitalized for more than 7 days were prospectively included. We investigat ed acquired colonization and nosocomial infection with SAMR or A. baumanii for 87 patients not colonized by SAMR or A. baumanii on admission. The colo nization acquisition rate was 56% for MRSA and 27% for A. baumanii. infecti on incidence (cases per 1,000 patient-days) was 6.46 for MRSA and 1.61 for A. baumanii. On univariate analysis, acquired MRSA colonization was associa ted with longer ICU stays, longer mechanical ventilation and longer central venous catheterization. Multivariate analysis only showed an association w ith longer ICU stay. Acquired A. baumanii colonization was associated with SAPSII, longer mechanical ventilation, and longer central venous catheteriz ation in univariate analysis. Multivariate analysis only showed an associat ion with SAPSII and longer mechanical ventilation. In this study, SAMR or A . baumanii infections were not associated with colonization or clinical set ting or invasive procedures. (C) 2000 Editions scientifiques et medicales E lsevier SAS.