Prevalence and risk factors of MRSA, ESBL and MDR bacterial colonization upon admission to an Egyptian medical ICU

  • Ragai Fouda Kasr El Aini Faculty of Medicine, Cairo, Egypt
  • May Sherif Soliman Faculty of Medicine, Cairo University, Cairo, Egypt
  • Mervat Gaber ElAnany Faculty of Medicine, Cairo University, Cairo, Egypt
  • Maggie Abadeer Kasr El Aini Faculty of Medicine, Cairo, Egypt
  • Ghada Soliman Cairo University Hospitals, Cairo, Egypt
Keywords: ICU, colonization, MDR-GNB, MRSA, ESBL

Abstract

Introduction: Bacterial colonization of the skin and mucous membranes of intensive care unit (ICU) patients with virulent organisms such as methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase (ESBL) producers, and multidrug-resistant Gram-negative bacteria (MDR-GNB) frequently results in life-threatening infections. Universal screening of ICU patients upon admission has been suggested. The aim of the current study was to evaluate the prevalence and pattern of MRSA, ESBL, and MDR-GNB colonization in patients upon admission to an Egyptian medical ICU, along with the related demographic and clinical risk factors.

Methodology: Throat, axillary, and groin swabs were obtained from all study participants in addition to rectal swabs from consenting patients. These swabs were screened for MRSA, ESBL, and MDR-GNB.

Results: Of the patients included in the study, 33%, 13%, and 63% were colonized with ESBL, MDR-GNB, and MRSA organisms, respectively. Those suffering from a more severe disease with a simplified acute physiology score II (SAPS II) > 29 demonstrated higher levels of MDR-GNB colonization upon admission, while MDR-GNB or ESBL colonization upon admission was associated with higher ICU mortality.

Conclusions: Colonization of ICU patients with superbugs upon admission has an impact on outcome and mortality. In this Egyptian example, colonization rates were higher than in other literature reports, demonstrating the need for routine screening and decolonization, if applicable.

Author Biographies

Ragai Fouda, Kasr El Aini Faculty of Medicine, Cairo, Egypt
Assistant Professor of Internal medicine
May Sherif Soliman, Faculty of Medicine, Cairo University, Cairo, Egypt
Lecturer of Clinical Pathology, Specialized in Clinical Microbiology
Mervat Gaber ElAnany, Faculty of Medicine, Cairo University, Cairo, Egypt
Professor of Clinical pathology, specialized in Clinical Microbiology
Maggie Abadeer, Kasr El Aini Faculty of Medicine, Cairo, Egypt
Lecturer of Internal Medicine
Ghada Soliman, Cairo University Hospitals, Cairo, Egypt
Fellow of Clinical Microbiology
Published
2016-04-28
How to Cite
1.
Fouda R, Soliman MS, ElAnany MG, Abadeer M, Soliman G (2016) Prevalence and risk factors of MRSA, ESBL and MDR bacterial colonization upon admission to an Egyptian medical ICU. J Infect Dev Ctries 10:329-336. doi: 10.3855/jidc.6798
Section
Original Articles