© The Board of Management and Trustees of the British Journal of Anaesthesia 2004
CORRESPONDENCE |
Methicillin-resistant Staphylococcus aureus in the critically ill
Editor—We read with great interest the review article on MRSA in the critically ill,1 in which the authors stressed the high risk of infection in intensive care patients. Recently, we presented the case of a patient who died in our ITU, at our hospital's grand round. We gave his cause of death on the death certificate as methicillin-resistant Staphylococcus aureus (MRSA) septicaemia secondary to MRSA pneumonia. The 47-yr-old patient had a previous history of controlled asthma. He had had no hospital treatment in the past. He needed level 3 critical care treatment after acute deterioration in his asthma control attributable to a presumed viral infection, and was transferred to our unit. His admission MRSA screen was negative. Subsequently he developed septic shock and multi-organ failure. A chest x-ray showed new infiltrates consistent with hospital-acquired pneumonia and sputum and blood cultures grew MRSA. He died 16 days after admission despite treatment with vancomycin, fusidic acid and rifampicin. Post-mortem examination showed bilateral multiple small lung abscesses consistent with staphylococcal infection. MRSA was grown from these.Your review article has highlighted the issue of MRSA as a primary cause of death in critical care that is being increasingly reported and has helped us in documenting our case. We have also been able to stress upon our hospital colleagues that intensive care patients have a combination of risk factors that makes them especially prone to nosocomial infection and the Critical Care Unit in any hospital will continue to have the highest infection rates, particularly with MRSA (Fig. 1). We also believe that scrupulous attention to hand hygiene and continued surveillance are the most important initial steps in infection control.
|
Wolverhampton, UK
References
1 Hardy KJ, Hawkey PM, Gao F, Oppenheim BA. Methicillin-resistant Staphylococcus aureus in the critically ill. Br J Anaesth 2004; 92: 121–30
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||