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

Details

• Alternative Title:
  J Hosp Infect
• Personal Author:
  Ham, D.C. ; See, I. ; Novosad, S. ; Crist, M. ; Mahon, G. ; Fike, L. ; Spicer, K. ; Talley, P. ; Flinchum, A. ; Kainer, M. ; Kallen, A.J. ; Walters, M.S.
• 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:
  Bloodstream Infection Healthcare-associated Infections Meticillin-resistant Staphylococcus Aureus
• Source:
  J Hosp Infect.
• Pubmed ID:
  32283173
• Pubmed Central ID:
  PMC7857529
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d99cc335af5e90a537a07de0d49c06fd1d4ac07cef286cb7fbedbf078c660a4d
• Download URL:
  https://stacks.cdc.gov/view/cdc/102175/cdc_102175_DS1.pdf
• File Type:
  [PDF - 72.25 KB ]