Staphylococcus aureus Resistente a la Meticilina en el hospital Son Llàtzer (2003-2012)incidencia, colonización y sensibilidad antibiótica

Abstract

OBJECTIVES: Examine the temporal evolution of the incidence of Methicillin-resistant Staphylococcus aureus (MRSA), epidemiological aspects of the relationship clinical sample-colonization and antibiotic resistance. METHODS: MRSA incident cases at Son Llàtzer Hospital in Palma during 10 years (January 2003 to December 2012). Two types of studies: an ecological of temporal evolution and a transversal descriptive one. Principal variables: clinical sample where MRSA were isolated, nares or/and cutaneous colonization, and resistance to antibiotics for clinical sample-colonization. Methods of classical analyses of times-series were used (tendency, seasonality, cyclical components and irregular variations) as well as the Poisson models. Univariate, bivariate and multivariate statistical analyses were undertaken. RESULTS: 691 cases were studied, 688 with clinical samples. Mean age was 68.2 years (CI95%=66.8-69.6), 417 men (60.3%). 30% diagnosed in Emergencies and 9% in ICU. Annual mean of cases 69 (CI95%=61.8–76.4) with an ascendant global annual tendency. Monthly mean of cases 5.75 (CI95%=5.27–6.23) with a slightly ascendant global monthly tendency. The endemic channels documented that there was an epidemic situation for 2 months in 2013 and during 2014 it remained in a security epidemiological situation. MRSA isolated in samples from wounds 46.7% and in respiratory 30.6%. They had nares colonization 53.5% and 38.4% cutaneous. At the bivariate level, wounds and respiratory samples were associated to nares colonization. Urine samples were associated to cutaneous colonization. At the multivariate level, the variables that better explained the presence of MRSA in wound samples were to be men, over 65 years old and have nares colonization. For MRSA in respiratory samples were to be men over 65 years old and nares colonization. For MRSA in urine samples, to be over 65 years old and have cutaneous colonization. Most of the antibiotics tested featured lower degrees of resistance than those stated in literature, except Quinolones whose levels were high. CONCLUSIONS: The temporal evolution of the MRSA incident cases was aleatory. Neither a season nor a cyclic component was observed. MRSA was mainly isolated in wound and respiratory samples. Nares colonization was the most frequent. Most of the antibiotics tested have shown lower resistance percentage than published in the literature.