Prevalence and acquisition of MRSA amongst patients admitted to a tertiary-care hospital in brazil

A cohort of randomly selected patients admitted to emergency and clinical wards at our hospital was followed until discharge. Nasal swabs were taken for identification of MRSA-colonized patients and detection of SCCmecA in positive cultures, at admission and weekly thereafter. Multivariate analysis using a log-binomial analysis was used to identify risk factors for colonization.After screening 297 adult patients and 176 pediatric patients, the prevalence of MRSA at admission was 6.1% (95%CI, 3.6% to 9.4%), in the adult population and 2.3% (95%CI, 0.6% to 5.7%), for children. From multivariate analysis, the risk factors associated with colonization in adults were: age above 60 years (P = 0.019) and hospitalization in the previous year (P = 0.022). Incidence analysis was performed in 276 MRSA-negative patients (175 adults and 101 children). Acquisition rate was 5.5/1,000 patient-days for adults (95%CI, 3.4 to 8.5/1,000 patients-days), and 1.1/1,000 patient-days for children (95%CI, 0.1 to 4.0/1,000 patients-days).The identification of MRSA carriers is a step towards establishing a control policy for MRSA, and helps to identify measures needed to reduce colonization pressure and to decrease the high acquisition rate in hospitalized patients.Methicillin-resistant Staphylococcus aureus (MRSA) is cross-transmitted in hospital settings, and has a high impact not only on patient morbidity and mortality but also on hospitalization costs. Worldwide, it has been endemic in many healthcare facilities since the 1990 s [1]. MRSA remains a major pathogen in nosocomial infections in developing countries [2] and in Latin America, according to SENTRY [3].The fact that a patient can harbor MRSA at hospital admission has consequences not just for the choice of patient treatment: it also impacts on the effectiveness of infection control in the hospital. MRSA reservoir at hospital can make other measures of infection control not as effective, thereby causing pathogen transmission to cont