Methicillin-Resistant Staphylococcus aureus in Patients With Congenital Heart Disease in the Pediatric Intensive Care Unit

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonization has been recognized as a significant problem among hospitalized patients. Available data about prevalence of MRSA among children with congenital heart disease (CHD) are minimal. The aim of the study was to determine the prevalence of MRSA colonization and to identify risk factors for MRSA colonization among children <19 years old with CHD admitted to a pediatric intensive care unit (PICU). Methods: Admission and weekly MRSA nasal surveillance testing was performed, and patients were stratified into six risk groups based on the Risk Adjustment for Congenital Heart Surgery-1 Method. The MRSA-colonized children were compared to the MRSA noncolonized children. Results: During the 3-year study period, there were 372 admissions of children with CHD to the PICU. Of the 372, 72 (19.4%) had no surveillance cultures performed or had no prior history of MRSA and were excluded from further analysis. Of the remaining 300 admissions, 29 (9.7%) (263 individual children) were found to be colonized. The mean age of the 263 children when first admitted to the PICU was 3.29 years (range 0.03-18.30, median 0.66). Age distribution was not significantly different between the colonized and noncolonized groups ( P = .236). Gender ( P = .667), race ( P = .837), and CHD complexity ( P = .395) were not significantly associated with colonization. The odds of being colonized if previously hospitalized were 4.42 times greater than if not previously hospitalized (95% confidence interval 1.89, 10.34). Conclusion: Routine MRSA surveillance should be performed in patients with CHD to identify colonized patients.