Methicillin Resistant Staphylococcus Aureus in Ventilator Associated ‎Pneumonia in Toxicological Intensive Care Unit

Background: Methicillin resistant Staphylococus Aureus (MRSA) is a cause of ‎nosocomial infections at intensive care unit (ICU), which imposes a high mortality and ‎morbidity on the health care systems.‎ The objective of this study was to evaluate the role of MRSA in patients with clinically ‎suspected ventilator associated pneumonia (VAP) in toxicological ICU admitted ‎patients.Methods: This cross-sectional study was performed over a period of six months from ‎August 2009 to February 2010. A total of 84 patients with clinically suspected VAP were ‎selected from all 381 ICU admitted patients under mechanical ventilation for more than ‎‎48 hours. MRSA Screen Agar was used to detect resistance in Staph aureus ‎specimens. MRSA was determined as the main outcome.‎ Results: MRSA was the cause in 54% of Staph aureus infected VAPs. Although ‎MRSA infection was not significantly associated with age, gender, cause of poisoning, ‎chronic disease, paraclinical findings, length of hospital stay, and antibiotic prescription ‎‎(P>0.05 for all comparisons), it was reported higher in those who expired than those ‎who survived (66.7% vs. 31.9%, P<0.012)‎.Conclusion: In the main referral toxicological ICU in Tehran, in more than 1 of 3 ‎clinically suspected VAP cases, MRSA was seen which was associated with the poorer ‎outcome, higher inpatient mortality.‎