Background : The aim of this study was to investigate the remodeling effect of 28-bed MICU of a 2100- bed tertiary care single hospital on the serial changes in the prevalence of MDR infection. 

  Method : All patients’ data with ICU- Acquired Infection (IAI) between January 2002 and June 2002 (before remodeling), October 2002 and March 2003 (after remodeling), and October 2003 and March 2004 (1 years after remodeling) were prospectively gathered. We defined the MDR pathogens as Methicillin- resistant Staphylococcus aureus (MRSA), third generation cephalosporin- resistant Acinetobacter baumani (ISAB), Imipenem- intermediated Acinetobacter baumani (IIAB), Imipenem- resistant Acinetobacter baumani (IRAB), Expanded spectrum beta- lactamase bacilli (ESBL), Imipenem- resistant Pseudomonas aeruginosa (IRPA) and Vancomycin - resistant Enterococci (VRE). 

  Result : There were no difference in the episode of IAI at each period were 16.4%, 17.8%, 27.5% and the MDR pathogen infection were occurred 42, 35, 68 episodes in each. Episodes of MRSA , ISAB, ESBL, IRPA, VRE had no difference in each period. But Episodes of IIAB ( 4, 1, 0; 5.4%, 1.3%, 0%; p=0.017 ), IRAB ( 5, 0, 1; 6.8%, 0%, 0.8%; p=0.005 ) were decreased after remodeling a MICU. There were no difference in ICU stay, the day of using mechanical ventilation, the day of using a central line, and ICU mortality during the study period. 

   Conclusion : The incidence and outcome of IAI caused by MDR pathogen was no difference after the remodeling of the MICU. There was decrease in incidence of IAI caused by IRAB, IIAB after remodeling.