Details:

Alternative Title:
Clin Infect Dis
Publisher's site:
http://dx.doi.org/10.1093/cid/civ777
Personal Author:
Epstein, Lauren ; Mu, Yi ; Belflower, Ruth ; Scott, Janine ; Ray, Susan ; ... More +
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. Less -
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.


Subject:
[+]
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
Bacteremia
Methicillin-Resistant Staphylococcus Aureus

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
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:f2fbf091187b17c2e2b5874ec3338d8d720f982f52de50310bd5143f9fe1c8d1
File Type:

Supporting Files

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