Methicillin-resistant Staphylococcus aureus (MRSA) colonization significantly increases the risk of subsequent MRSA infection, with a substantial proportion of MRSA infections occurring after discharge from the hospital. This according to a study that followed patients from the Department of Veterans Affairs longitudinally to estimate the difference in infection rates for those who were not colonized, those who were colonized on admission (importers), and those who acquired MRSA during their stay. Researchers examined MRSA infections that occurred prior to discharge and at 30, 90, 180, and 365 after discharge. They then constructed a dataset of 985,626 first admissions from January 2008 through December 2015 who had surveillance tests performed for MRSA carriage. They found:
- The MRSA infection rate across the predischarge and 180-day postdischarge time period was 5.5% in importers and 7.0% in acquirers without a direct admission to the intensive care unit (ICU) and 11.4% in importers and 11.7% in acquirers who were admitted directly to the ICU.
- The predischarge hazard ratio (HR) for MRSA infection was 29.6 for acquirers compared to those not colonized.
- 63.9% of all MRSA pre- and postdischarge infections among importers and 61.2% among acquirers occurred within 180 days after discharge.
Nelson RE, Evans ME, Simbartl L, et al. Methicillin-resistant Staphylococcus aureus colonization and pre- and post-hospital discharge infection risk. [Published online ahead of print August 11, 2018]. Clin Infect Dis. doi:10.1093/cid/ciy507.
This Week's Must Reads
IDSA Updates Seasonal Influenza Guidelines, Clin Infect Dis; ePub 2018 Dec 19; Uyeki, et al
Efficacy of Cell-Cultured & Egg-Based Influenza Vaccines, J Infect Dis; ePub 2018 Dec 18; Izurieta, et al
Prevention of Influenza Hospitalization in US Adults, J Infect Dis; ePub 2018 Dec 14; Ferdinands, et al
Clinical & Virologic & Characteristics of Zika Virus Infection, Open Forum Infect Dis; ePub 2018 Dec 19; El Sahly, et al
Importations of Measles Virus in the US, J Infect Dis; ePub 2018 Dec 9; Lee, et al
Must Reads in Antimicrobial-resistant infections
PCT-Guided Antibiotic Therapy in LRTIs, Open Forum Infect Dis; ePub 2018 Dec 3; Townsend, et al
Pyrosequencing for the Clinical Management of TB, Clin Infect Dis; ePub 2018 Nov 1; Lowenthal, et al
GI Microbiota Disruption with CRPA in ICU Patients, Clin Infect Dis; ePub 2018 Nov 1; Pettigrew, et al
New IDSA Guideline for Management of OPAT, Clin Infect Dis; ePub 2018 Nov 13; Norris, et al
OPAT Outcomes in SNFs vs HHCs, Open Forum Infect Dis; ePub 2018 Oct 24; Townsend, et al