Risk Factors for Invasive Methicillin-Resistant Staphylococcus aureus Infection After Recent Discharge From an Acute-Care Hospitalization, 2011–2013

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Epstein, Lauren ; Mu, Yi ; Belflower, Ruth ; Scott, Janine ; Ray, Susan ; Dumyati, Ghinwa ; Felsen, Christina ; Petit, Susan ; Yousey-Hindes, Kimberly ; Nadle, Joelle ; Pasutti, Lauren ; Lynfield, Ruth ; Warnke, Linn ; Schaffner, William ; Leib, Karen ; Kallen, Alexander J. ; Fridkin, Scott K. ; Lessa, Fernanda C.
• Description:
  Background.
  
  Significant progress has been made in reducing methicillin-resistant Staphylococcus aureus (MRSA) infections among hospitalized patients. However, the decreases in invasive MRSA infections among recently discharged patients have been less substantial. To inform prevention strategies, we assessed risk factors for invasive MRSA infection after acute-care hospitalizations.
  
  Methods.
  
  We conducted a prospective, matched case-control study. A case was defined as MRSA cultured from a normally sterile body site in a patient discharged from a hospital within the prior 12 weeks. Eligible case patients were identified from 15 hospitals across 6 US states. For each case patient, 2 controls were matched for hospital, month of discharge, and age group. Medical record reviews and telephone interviews were performed. Conditional logistic regression was used to identify independent risk factors for post-discharge invasive MRSA.
  
  Results.
  
  From 1 February 2011 through 31 March 2013, 194 case patients and 388 matched controls were enrolled. The median time between hospital discharge and positive culture was 23 days (range, 1–83 days). Factors independently associated with post-discharge MRSA infection included MRSA colonization (matched odds ratio [mOR], 7.71; 95% confidence interval [CI], 3.60–16.51), discharge to a nursing home (mOR, 2.65; 95% CI, 1.41–4.99), presence of a chronic wound during the post-discharge period (mOR, 4.41; 95% CI, 2.14–9.09), and discharge with a central venous catheter (mOR, 2.16; 95% CI, 1.13–4.99) or a different invasive device (mOR, 3.03; 95% CI, 1.24–7.39) in place.
  
  Conclusions.
  
  Prevention efforts should target patients with MRSA colonization or those with invasive devices or chronic wounds at hospital discharge. In addition, MRSA prevention efforts in nursing homes are warranted.
  
  
• Subjects:
  Article Bacteremia Case-Control Studies Epidemiology Female Humans Male Methicillin-resistant Staphylococcus Aureus Middle Aged Patient Discharge Prospective Studies Risk-factors Risk Factors Staphylococcal Infections

  More +
• Source:
  Clin Infect Dis. 62(1):45-52
• Pubmed ID:
  26338787
• Pubmed Central ID:
  PMC6557163
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Volume:
  62
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:f2fbf091187b17c2e2b5874ec3338d8d720f982f52de50310bd5143f9fe1c8d1
• Download URL:
  https://stacks.cdc.gov/view/cdc/79238/cdc_79238_DS1.pdf
• File Type:
  [PDF - 231.27 KB ]