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Hospitalizations among family members increase the risk of MRSA infection in a household
Journal article   Open access   Peer reviewed

Hospitalizations among family members increase the risk of MRSA infection in a household

Aaron C Miller, Alan T Arakkal, Daniel K Sewell, Alberto M Segre, Bijaya Adhikari, Philip M Polgreen and CDC MInD-Healthcare Group
Infection control and hospital epidemiology, Vol.45(7), pp.826-832
07/2024
DOI: 10.1017/ice.2024.106
PMCID: PMC11439592
PMID: 39106984
Appears in  UI Libraries Support Open Access
url
https://doi.org/10.1017/ice.2024.106View
Published (Version of record) Open Access

Abstract

Estimate the risk for household transmission of Methicillin-Resistant Staphylococcus aureus (MRSA) following exposure to infected family members or family members recently discharged from a hospital.OBJECTIVEEstimate the risk for household transmission of Methicillin-Resistant Staphylococcus aureus (MRSA) following exposure to infected family members or family members recently discharged from a hospital.Analysis of monthly MRSA incidence from longitudinal insurance claims using the Merative MarketScan Commercial and Medicare (2001-2021) databases.DESIGNAnalysis of monthly MRSA incidence from longitudinal insurance claims using the Merative MarketScan Commercial and Medicare (2001-2021) databases.Visits to inpatient, emergency department, and outpatient settings.SETTINGVisits to inpatient, emergency department, and outpatient settings.Households with ≥2 family members enrolled in the same insurance plan for the entire month.PATIENTSHouseholds with ≥2 family members enrolled in the same insurance plan for the entire month.We estimated a monthly incidence model, where enrollees were binned into monthly enrollment strata defined by demographic, patient, and exposure characteristics. Monthly incidence within each stratum was computed, and a regression analysis was used to estimate the incidence rate ratio (IRR) associated with household exposures of interest while accounting for potential confounding factors.METHODSWe estimated a monthly incidence model, where enrollees were binned into monthly enrollment strata defined by demographic, patient, and exposure characteristics. Monthly incidence within each stratum was computed, and a regression analysis was used to estimate the incidence rate ratio (IRR) associated with household exposures of interest while accounting for potential confounding factors.A total of 157,944,708 enrollees were included and 424,512 cases of MRSA were identified. Across all included enrollees, exposure to a family member with MRSA in the prior 30 days was associated with significantly increased risk of infection (IRR: 71.03 [95% CI, 67.73-74.50]). After removing enrollees who were hospitalized or exposed to a family member with MRSA, exposure to a family member who was recently discharged from the hospital was associated with increased risk of infection (IRR: 1.44 [95% CI, 1.39-1.49]) and the risk of infection increased with the duration of the family member's hospital stay (P value < .001).RESULTSA total of 157,944,708 enrollees were included and 424,512 cases of MRSA were identified. Across all included enrollees, exposure to a family member with MRSA in the prior 30 days was associated with significantly increased risk of infection (IRR: 71.03 [95% CI, 67.73-74.50]). After removing enrollees who were hospitalized or exposed to a family member with MRSA, exposure to a family member who was recently discharged from the hospital was associated with increased risk of infection (IRR: 1.44 [95% CI, 1.39-1.49]) and the risk of infection increased with the duration of the family member's hospital stay (P value < .001).Exposure to a recently hospitalized and discharged family member increased the risk of MRSA infection in a household even when the hospitalized family member was not diagnosed with MRSA.CONCLUSIONSExposure to a recently hospitalized and discharged family member increased the risk of MRSA infection in a household even when the hospitalized family member was not diagnosed with MRSA.
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