Risk factors for the development of active methicillin-resistant Staphylococcus aureus (MRSA) infection in patients colonized with MRSA at hospital admission

Jose Cadena, Josephine Thinwa, Elizabeth A. Walter, Christopher R. Frei

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1617-1621
Number of pages5
JournalAmerican Journal of Infection Control
Volume44
Issue number12
DOIs
StatePublished - Dec 1 2016
Externally publishedYes

Keywords

  • Active surveillance
  • dialysis
  • hemiplegia
  • MRSA

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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