Investigation of hospital-onset meticillin-resistant Staphylococcus aureus bloodstream infections at eight high-burden acute care facilities in the USA, 2016
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Investigation of hospital-onset meticillin-resistant Staphylococcus aureus bloodstream infections at eight high-burden acute care facilities in the USA, 2016

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  • English
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    Details:

    • Alternative Title:
      J Hosp Infect
    • Personal Author:
    • Description:
      Background:

      Despite large reductions from 2005 to 2012, hospital-onset meticillin-resistant Staphylococcus aureus bloodstream infections (HO MRSA BSIs) continue to be a major source of morbidity and mortality.

      Aim:

      To describe risk factors for and underlying sources of HO MRSA BSIs.

      Methods:

      This study investigated HO MRSA BSIs at eight high-burden short-stay acute care hospitals. A case was defined as first isolation of MRSA from a blood specimen collected in 2016 on or after hospital day 4 from a patient without an MRSA-positive blood culture in the preceding 2 weeks. Case demographics and risk factors were reviewed by medical record abstraction. The potential clinical source(s) of infection were determined by consensus by a clinician panel.

      Findings:

      Of the 195 eligible cases, 186 were investigated. Cases were predominantly male (63%) and the median age was 57 years (range 0–92 years). In the 2 weeks preceding BSI, 88% of cases had indwelling devices, 31% underwent a surgical procedure and 18% underwent dialysis. The most common locations of attribution were intensive care units (ICUs) (46%) and step-down units (19%). The most commonly identified non-mutually exclusive clinical sources were central venous catheters (46%), non-surgical wounds (17%), surgical site infections (16%), non-ventilator healthcare-associated pneumonia (13%) and ventilator-associated pneumonia (11%).

      Conclusions:

      Device- and procedure-related infections were common sources of HO MRSA BSIs. Prevention strategies focused on improving adherence to existing prevention bundles for device-and procedure-associated infections and on source control for ICU patients, patients with certain indwelling devices, and patients undergoing certain high-risk surgeries are being pursued to decrease the burden of HO MRSA BSIs at these facilities.

    • Keywords:
    • Source:
      J Hosp Infect.
    • Pubmed ID:
      32283173
    • Pubmed Central ID:
      PMC7857529
    • Document Type:
      Journal Article
    • Funding:
      CC999999/ImCDC/Intramural CDC HHSUnited States/
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