Colonization of Methicillin-resistant Staphylococcus aureus (MRSA) and History of Hospitalization: how strong do they correlate in ICU Patients?

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the Multidrug-resistant organisms (MDRO) which has been quite an endemic in many healthcare facilities, especially in the Intensive Care Unite (ICU) of hospitals. History of patients’ hospitalization before ICU admission has been considered to be one of the risk factors for MRSA colonization in patients. Problems arised after knowing that ICU patients with MRSA colonization are at high risk of MRSA infection. Therefore, we require data of MRSA colonization associated history of patients’ hospitalization before ICU admission in hopes that the incidence of MRSA colonization in Indonesia hospitals can be reduced. This is an analytical cross sectional study using secondary data results from microbiological examination of swabs (nose, underarms, and rectum) and medical records of 109 patients from the Central ICU RSCM on January 2011 until August 2011. Sample selection was conducted by consecutive sampling. Microbiological examination results which were used in this study were the results of MRSA resistance test both in patients who had history of hospitalization before ICU admission and those who did not. Data was analyzed using Chi-squared test. The result of comparing data between the proportion of patients with positive MRSA colonization and had history of hospitalization to the proportion of patients with positive MRSA colonization but did not have history of hospitalization was PR (prevalence ratio)=1,206 with significance value p=0,307 and CI95% -3,087; 5,499. This suggests that history of patients’ hospitalization before ICU admission was not the only factor to affect MRSA colonization. Antibiotic administrations and prior contact with MRSA carrier in the community might be other risk factors which may obscure this result. It indicates that hospitals should conduct routine MRSA colonization screening to all patients, regardless of their history of hospitalization, as a standard precaution for infection control.