Journal article
Long-term risk for readmission, methicillin-resistant Staphylococcus aureus (MRSA) infection, and death among MRSA-colonized veterans
Antimicrobial agents and chemotherapy, Vol.57(3), pp.1169-1172
03/2013
DOI: 10.1128/AAC.01968-12
PMCID: PMC3591925
PMID: 23254427
Abstract
While numerous studies have assessed the outcomes of methicillin-resistant S. aureus (MRSA) colonization over the short term, little is known about longer-term outcomes after discharge. An assessment of long-term outcomes could provide information about the utility of various MRSA prevention approaches. A matched-cohort study was performed among Veterans Affairs (VA) patients screened for MRSA colonization between the years 2007 and 2009 and followed to evaluate outcomes until 2010. Cox proportional-hazard models were used to evaluate the association between MRSA colonization and long-term outcomes, such as infection-related readmission and crude mortality. A total of 404 veterans were included, 206 of whom were MRSA carriers and 198 of whom were noncarriers. There were no culture-proven MRSA infections on readmission among the noncarriers, but 13% of MRSA carriers were readmitted with culture-proven MRSA infections on readmission (P < 0.01). MRSA carriers were significantly more likely to be readmitted, to be readmitted more than once due to proven or probable MRSA infections, and to be readmitted within 90 days of discharge than noncarriers (P < 0.05). Infection-related readmission (adjusted hazard ratio [HR] = 4.07; 95% confidence interval [CI], 2.16 to 7.67) and mortality (adjusted HR = 2.71; 95% CI, 1.87 to 3.91) were significantly higher among MRSA carriers than among noncarriers after statistically adjusting for potential confounders. Among a cohort of VA patients, MRSA carriers are at high risk of infection-related readmission, MRSA infection, and mortality compared to noncarriers. Noncarriers are at very low risk of subsequent MRSA infection. Future studies should address whether interventions such as nasal or skin decolonization could result in improved outcomes for MRSA carriers.
Details
- Title: Subtitle
- Long-term risk for readmission, methicillin-resistant Staphylococcus aureus (MRSA) infection, and death among MRSA-colonized veterans
- Creators
- Nestor M Quezada Joaquin - Division of Infectious Diseases, Department of Internal Medicine, Carver College of Medicine, Iowa City, IA, USADaniel J DiekemaEli N PerencevichGeorge BaileyPatricia L WinokurMarin L Schweizer
- Resource Type
- Journal article
- Publication Details
- Antimicrobial agents and chemotherapy, Vol.57(3), pp.1169-1172
- DOI
- 10.1128/AAC.01968-12
- PMID
- 23254427
- PMCID
- PMC3591925
- NLM abbreviation
- Antimicrob Agents Chemother
- ISSN
- 1098-6596
- eISSN
- 1098-6596
- Publisher
- United States
- Grant note
- KL2 RR024980 / NCRR NIH HHS 3KL2 RR024980-04S1 / NCRR NIH HHS
- Language
- English
- Date published
- 03/2013
- Academic Unit
- Epidemiology; Pathology; Medicine Administration; Internal Medicine
- Record Identifier
- 9983779292202771
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