Patients with tracheostomy as a primary risk factor for methicillin-resistant Staphylococcus aureus carriage in emergency intensive care unit admissions: A retrospective single-center observational study

Methicillin-resistant Staphylococcus aureus (MRSA) is often found in intensive care units and has a negative impact on patients. In order to prevent cross-transmission of MRSA from potential MRSA carriers to noncarriers, we investigated risk factors for MRSA carriage in patients admitted to the ICU on an emergency basis who are at high risk for MRSA spread. A retrospective observational study was conducted on adult patients who were admitted in an emergency to the ICU between November 1, 2019 and February 28, 2022 and remained in the ICU for at least 48 hours. Patients with a history of MRSA detection or MRSA detected within 48 hours of admission to the ICU were defined as the "carrier" group, while other patients were defined as the "noncarrier" group. Risk factors associated with MRSA carriage in patients admitted to the ICU on an emergency basis were examined by collecting observable factors from medical records during the patient's admission. The total number of eligible emergency admissions was 303 patients; 190 (63%) were male, and their mean age (±standard deviation) was 73 (13.9) years. There were 45 patients (17%) in the MRSA-carrier group. Logistic regression analysis showed that tracheostomy was an independent risk factor (odds ratio: 4.9, 95% confidence interval: 1.7-14.2, P = .003). This study revealed that patients with tracheostomies were more likely to carry MRSA into patients admitted to the ICU on an emergency basis. For these patients, infection control measures for MRSA should be implemented 48 hours after ICU admission.