Post-discharge mortality in patients hospitalized with MRSA infection and/or colonization

• Authors: A Sharma, Atlanta Veterans Affairs Medical Center; C Rogers, Atlanta Veterans Affairs Medical Center; David Rimland, Emory University; C Stafford, Atlanta Veterans Affairs Medical Center; Sarah Satola, Emory University; E Crispell, Atlanta Veterans Affairs Medical Center; Robert Gaynes, Emory University
• Journal Title: EPIDEMIOLOGY AND INFECTION
• Volume: Volume 141, Number 6
• Publisher: CAMBRIDGE UNIV PRESS | 2013-06-01, Pages 1187-1198
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1017/S0950268812001963
• Subjects: Health Sciences, Epidemiology; Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Public, Environmental & Occupational Health; Infectious Diseases; words: Epidemiology; hygiene and hospital infections; infectious disease control; methicillin-resistant S. aureus (MRSA); prevention; RESISTANT STAPHYLOCOCCUS-AUREUS; TERM-CARE FACILITY; METHICILLIN-RESISTANCE; RISK-FACTORS; NASAL COLONIZATION; BACTEREMIA; OUTCOMES; CARRIAGE; DURATION; PERFORMANCE

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) infection is known to increase in-hospital mortality, but little is known about its association with long-term health. Two hundred and thirty-seven deaths occurred among 707 patients with MRSA infection at the time of hospitalization and/or nasal colonization followed for almost 4 years after discharge from the Atlanta Veterans Affairs Medical Center, USA. The crude mortality rate in patients with an infection and colonization (23·57/100 person-years) was significantly higher than the rate in patients with only colonization (15·67/100 person-years, P = 0·037). MRSA infection, hospitalization within past 6 months, and histories of cancer or haemodialysis were independent risk factors. Adjusted mortality rates in patients with infection were almost twice as high compared to patients who were only colonized: patients infected and colonized [hazard ratio (HR) 1·93, 95% confidence interval (CI) 1·31-2·84]; patients infected but not colonized (HR 1·96, 95% CI 1·22-3·17). Surviving MRSA infection adversely affects long-term mortality, underscoring the importance of infection control in healthcare settings. Copyright © 2012 Cambridge University Press.