Increasing Burden of Methicillin-Resistant Staphylococcus aureus Hospitalizations at US Academic Medical Centers, 2003–2008
Published Date:Jun 11 2012
Source:Infect Control Hosp Epidemiol. 2012; 33(8):782-789.
Keywords:Academic Medical Centers
International Classification Of Diseases
Methicillin-Resistant Staphylococcus Aureus
Pubmed Central ID:PMC3682488
Funding:1R01AL067584-04/PHS HHS/United States
AL040481-08A1S1/PHS HHS/United States
HHSN272200700031C/PHS HHS/United States
K23 AI095361/AI/NIAID NIH HHS/United States
R01 CI000373-03/CI/NCPDCID CDC HHS/United States
The incidence of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in the United States decreased during 2005–2008, but noninvasive community-associated MRSA (CA-MRSA) infections also frequently lead to hospitalization. We estimated the incidence of all MRSA infections among inpatients at US academic medical centers (AMCs) per 1,000 admissions during 2003–2008.
Retrospective cohort study.
SETTING AND PARTICIPANTS
Hospitalized patients at 90% of nonprofit US AMCs during 2003–2008.
Administrative data on MRSA infections from a hospital discharge database (University HealthSystem Consortium [UHC]) were adjusted for underreporting of the MRSA V09.0 International Classification of Diseases, Ninth Revision, Clinical Modification code and validated using chart reviews for patients with known MRSA infections in 2004–2005, 2006, and 2007.
The mean sensitivity of administrative data for MRSA infections at the University of Chicago Medical Center in three 12-month periods during 2004–2007 was 59.1%. On the basis of estimates of billing data sensitivity from the literature and the University of Chicago Medical Center, the number of MRSA infections per 1,000 hospital discharges at US AMCs increased from 20.9 (range, 11.1–47.7) in 2003 to 41.7 (range, 21.9–94.0) in 2008. At the University of Chicago Medical Center, among infections cultured more than 3 days prior to hospital discharge, CA-MRSA infections were more likely to be captured in the UHC billing–derived data than were healthcare-associated MRSA infections.
The number of hospital admissions for any MRSA infection per 1,000 hospital admissions overall increased during 2003–2008. Use of unadjusted administrative hospital discharge data or surveillance for invasive disease far underestimates the number of MRSA infections among hospitalized patients.
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