Below is a copy of an article from Anaesthesia and Intensive Care, published by the Australian Society of Anaesthetists
Airborne Methicillin-Resistant Staphylococcus Aureus (MRSA) in the Intensive Care Unit
Background: It is widely accepted that the mode of transmission of methicillin-resistant Staphylococcus aureus (MRSA) is via contact. A previous unpublished air sampling study in our old intensive care unit (ICU) suggested that MRSA might also be transmitted by the airborne route. Opening a new, MRSA-free ICU provided the opportunity to examine the hypothesis that airborne MRSA is important in the clinical setting.
Methods: A new extension of ICU was chosen as the study site. This 12 bed unit, ICU-1, contained 4 single rooms and 8 beds in an open area plan. Six locations, including two single rooms and four open beds areas, were chosen for collection of air samples from the first day of its opening in January 2001. Bed management practice dictated that MRSA colonised or infected patients were confined to single rooms unless the number exceeded the number of single rooms available. Air sampling was performed three times weekly over a period of 32 weeks. Air samples were collected directly onto an MRSA selective agar and processed using standard clinical microbiology techniques.
Findings: A total of 480 air samples were collected on 80 days. 39/480 (8.1%) samples were found to be MRSA positive of which 24/160 (15%) positive air samples were from the single rooms and 15/320 (4.7%) were from the open bed areas. A close correlation was found between the daily number of MRSA colonised or infected patients in ICU and the daily number of MRSA positive air samples cultures obtained (P<0.05, Spearman Rank). The frequency of positive cultures was significantly higher in the single rooms than in the open bed areas (P<0.05; (?2-test). The results from one of the single rooms showed a strong correlation between the presence of MRSA patients and MRSA positive air samples (P<0.05, Spearman Rank).
Interpretation: Our findings demonstrate the presence of airborne MRSA within our ICU. The presence of MRSA in air samples is strongly related to the presence and number of MRSA colonised patients in the unit.
The Correlation Between Airborne Methicillin-resistant Staphylococcus aureus with the Presence of MRSA Colonized Patients in a General Intensive Care Unit.
Location: Department of
Intensive Care Medicine, University of Sydney and Department of Pathology,
Nepean Hospital, Penrith, New South Wales
Address for reprints: Associate Professor A. S. McLean, Intensive Care Unit,
Nepean Hospital, University of Sydney, PO Box 63, Penrith, N.S.W. 2750
Acceptance date: November 26, 2003.
R. D. WILSON
Search PubMed M.B.B.S., F.R.C.P.A., M.A.S.M., Area Director, Nepean and Blue
Mountains Pathology Service, Nepean Hospital.
S. J. HUANG
Search PubMed PH.D., Honorary Associate and Senior Hospital Scientist, Department
of Intensive Care Medicine, University of Sydney, Nepean Hospital.
A. S. MCLEAN
Search PubMed M.B., Ch.B., F.R.A.C.P., F.J.F.I.C.M., Associate Professor,
Head of Critical Care Division, University of Sydney, Nepean Hospital.
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