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Community-Onset Invasive Methicillin-Resistant Staphylococcus Aureus Infections Following Hospital Discharge

Background: The majority of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in the United States are community-onset and occur in persons with recent health care exposure.

Methods: We performed a matched case-control study to identify risk factors for invasive MRSA infection among recently discharged patients. Cases had MRSA cultured from a normally sterile body site within 100 days following hospital discharge. Controls were matched on hospital, week of admission, and age.

Results: Among 77 cases, the most common types of invasive MRSA infection were bloodstream infection and osteomyelitis. Independent risk factors were a history of a MRSA-positive clinical culture from a superficial body site in the 12 months preceding the invasive infection (matched odds ratio [mOR], 23; 95% confidence interval [CI]: 3.7-142), hemodialysis (mOR, 21; 95% CI: 1.7-257), prior hospitalization length of stay >5 days (mOR, 4.5; 95% CI: 1.6-12), and male sex (mOR, 2.9; 95% CI: 1.1-7.9).

Conclusion: Risk factors for post discharge invasive MRSA infections can be identified prior to discharge and remain with the patient after the hospitalization ends. Measures to prevent community-onset invasive MRSA infections might start in the hospital but should also be evaluated in post discharge settings.

Author: Duffy J, Dumyati G, Bulens S, Namburi S, Gellert RN, Fridkin SK, Lessa FC

Citation: American Journal of Infection Control 41 (2013) 782-6, http://dx.doi.org/10.1016/j.ajic.2012.10.020

Published: 01/01/2012

Publication Type: Journal article

Publisher: American Journal of Infection Control