Methicillin resistant Staphylococcus aureus (MRSA) in the intensive care unit
- 1Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine
- 2Department of Pharmacy, Yale New Haven Hospital
- 3Surgical Intensive Care Units, Johns Hopkins University School of Medicine and Johns Hopkins University School of Nursing
- Correspondence to: Dr Pamela A Lipsett, Johns Hopkins Hospital, Department of Surgery, 600 N Wolfe Street, Blalock 685, Baltimore, MD 21287-4683, USA; plipsett{at}jhmi.edu
- Received 22 June 2001
- Accepted 20 February 2002
Abstract
Methicillin resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity and mortality worldwide. MRSA strains are endemic in many American and European hospitals and account for 29%–35% of all clinical isolates. Recent studies have documented the increased costs associated with MRSA infection, as well as the importance of colonisation pressure. Surveillance strategies have been proposed especially in high risk areas such as the intensive care unit. Pneumonia and bacteraemia account for the majority of MRSA serious clinical infections, but intra-abdominal infections, osteomyelitis, toxic shock syndrome, food poisoning, and deep tissue infections are also important clinical diseases. The traditional antibiotic therapy for MRSA is a glycopeptide, vancomycin. New antibiotics have been recently released that add to the armamentarium for therapy against MRSA and include linezolid, and quinupristin/dalfopristin, but cost, side effects, and resistance may limit their long term usefulness.
- GISA, glycopeptide intermediate S aureus
- ICU, intensive care unit
- MIC, minimal inhibitory concentration
- MRSA, methicillin resistant Staphylococcus aureus
- MSSA, methicillin sensitive S aureus, RR, relative risk
- VISA, S aureus with intermediate resistance to vancomycin
