Journal article
Identifying groups at high risk for carriage of antibiotic-resistant bacteria
Archives of internal medicine, Vol.166(5), pp.580-585
03/13/2006
DOI: 10.1001/archinte.166.5.580
PMID: 16534047
Abstract
No simple, cost-effective methods exist to identify patients at high risk for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci colonization outside intensive care settings. Without such methods, colonized patients are entering hospitals undetected and transmitting these bacteria to other patients. We aimed to develop a highly sensitive, simple-to-administer prediction rule to identify subpopulations of patients at high risk for colonization on hospital admission. We conducted a prospective cohort study of adult patients admitted to the general medical and surgical wards of a tertiary-care facility. Data were collected using electronic medical records and an investigator-administered questionnaire. Cultures of anterior nares and the perirectal area were also collected within 48 hours of admission. Among 699 patients who enrolled in this study, 697 underwent nasal cultures; 555, perirectal cultures; and 553, both. Patient self-report of a hospital admission in the previous year was the most sensitive variable in identifying patients colonized with methicillin-resistant Staphylococcus aureus or with either organism (sensitivity, 76% and 90%, respectively). A prediction rule requiring patients to self-report having received antibiotics and a hospital admission in the previous year would have identified 100% of patients colonized with vancomycin-resistant enterococci. In the high-risk groups defined by the prediction rule, the prevalence of colonization by methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, or either organism were 8.1%, 10.2%, and 15.0%, respectively. Patients with a self-reported previous admission within 1 year may represent a high-risk group for colonization by methicillin-resistant Staphylococcus aureus or vancomycin-resistant enterococci at hospital admission and should be considered for targeted active surveillance culturing.
Details
- Title: Subtitle
- Identifying groups at high risk for carriage of antibiotic-resistant bacteria
- Creators
- Jon P Furuno - Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201, USA. jfuruno@epi.umaryland.eduJessina C McGregorAnthony D HarrisJudith A JohnsonJennifer K JohnsonPatricia LangenbergRichard A VeneziaJoseph FinkelsteinDavid L SmithSandra M StraussEli N Perencevich
- Resource Type
- Journal article
- Publication Details
- Archives of internal medicine, Vol.166(5), pp.580-585
- Publisher
- United States
- DOI
- 10.1001/archinte.166.5.580
- PMID
- 16534047
- ISSN
- 0003-9926
- eISSN
- 1538-3679
- Grant note
- M01 RR16500 / NCRR NIH HHS R01 AI60859-01A1 / NIAID NIH HHS K23 AI01752-01A1 / NIAID NIH HHS
- Language
- English
- Date published
- 03/13/2006
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9983779291702771
Metrics
25 Record Views