Background
Patients who present to Veterans Affairs hospitals are screened for methicillin-resistant
Staphylococcus aureus (MRSA) colonization. Those who test positive are isolated during their hospital stay.
However, it is unknown which of these patients are most likely to subsequently develop
active MRSA infections.
Methods
This retrospective case-control study characterized risk factors for active MRSA infection
among patients colonized with MRSA at hospital admission. Potential demographic and
clinical risk factors were identified using electronic queries and manual chart abstraction;
data were compared by standard statistical tests, and variables with P ≤ .05 in bivariable analysis were entered into a multivariable logistic regression
model.
Results
There were 71 cases and 213 controls. Risk factors associated with MRSA infection
included diabetes mellitus with or without end organ damage (26% vs 14%, P = .02), hemiplegia (9% vs 2%, P = .01), chronic kidney disease (33% vs 20%, P = .03), postcolonization inpatient admission within 90 days (44% vs 29%, P = .03), surgery (41% vs 9%, P < .01), and dialysis (10% vs 3%, P = .02). On multivariable analysis, surgery during follow-up, dialysis during follow-up,
and hemiplegia remained significant.
Conclusions
Among patients with MRSA colonization, surgery or dialysis during follow-up and history
of hemiplegia were associated with subsequent MRSA infection. Knowledge of these risk
factors may allow for future targeted interventions to prevent MRSA infections among
colonized patients.
Key Words
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Article info
Publication history
Published online: June 29, 2016
Footnotes
Conflicts of Interest: None to report.
Disclaimer: The views expressed herein are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or the U.S. Government.
Identification
Copyright
Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.
