Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

MRSA Infections After Hospital Discharge

Clin Infect Dis; ePub 2018 Aug 11; Nelson, et al

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.

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