Background
This study assessed the relationship between nasal colonization and ventilator-associated
pneumonia (VAP) by Staphylococcus aureus, as well the role of the environment in the transmission of this organism.
Methods
We performed a cohort study of patients with VAP caused by methicillin-resistant S aureus (MRSA) or methicillin-sensitive S aureus during 2 years in an adult intensive care unit (ICU). All patients had nasal swab
specimens obtained at admission and during the ICU stay. Clinical samples also were
collected for analysis, as were samples from the hands of health care professionals
and the environment, and were typed using pulsed-field gel electrophoresis.
Results
S aureus VAP represented 12.5% of the cases, and statistical analysis identified colonization
as a risk factor for the development of this infection. MRSA was isolated from the
environment and hands, indicating the existence of a secondary reservoir. Molecular
typing revealed a polyclonal profile; however, clone J was the most frequent (45.5%)
among isolates of MRSA tested, with a greater profile of resistance than the other
isolates. There was strong evidence suggesting transmission of MRSA to patients from
the environment.
Conclusion
Nasal colonization for S aureus is a risk factor for development of VAP.
Key Words
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Article info
Publication history
Published online: July 25, 2013
Footnotes
This study was supported in part by the Coordination of Improvement of Higher Education Personnel (CAPES).
Conflict of interest: None to report.
Identification
Copyright
© 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
