Burden of Invasive Methicillin‐Resistant Staphylococcus aureus Infections in Nursing Home Residents
Year: 2018
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: To describe the epidemiology and incidence of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in nursing home (NH) residents, which has previously not been well characterized. DESIGN: Retrospective analysis of public health surveillance data. SETTING: Healthcare facilities in 33 U.S. counties. PARTICIPANTS: Residents of the surveillance area. MEASUREMENTS: Counts of NH-onset and hospital-onset (HO) invasive MRSA infections (cultured from sterile body sites) identified from the Centers for Disease Control and Prevention Emerging Infections Program (EIP) population-based surveillance from 2009 to 2013 were compared. Demographic characteristics and risk factors of NH-onset cases were analyzed. Using NH resident-day denominators from the Centers for Medicare and Medicaid Services Skilled Nursing Facility Cost Reports, incidence of NH-onset invasive MRSA infections from facilities in the EIP area was determined. RESULTS: A total of 4,607 NH-onset and 4,344 HO invasive MRSA cases were reported. Of NH-onset cases, median age was 74, most infections were bloodstream infections, and known risk factors for infection were common: 1,455 (32%) had previous MRSA infection or colonization, 1,014 (22%) had decubitus ulcers, 1,098 (24%) had recent central venous catheters, and 1,103 (24%) were undergoing chronic dialysis; 2,499 (54%) had been discharged from a hospital in the previous 100 days. The in-hospital case-fatality rate was 19%. The 2013 pooled mean incidence of NH-onset invasive MRSA infections in the surveillance area was 2.4 per 100,000 patient-days. CONCLUSION: More NH-onset than HO cases occurred, primarily in individuals with known MRSA risk factors. These data reinforce the importance of infection prevention practices during wound and device care in NH residents, especially those with a history of MRSA infection or colonization.
DOI: 10.1111/jgs.15451
Institutions: Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Epidemic Intelligence Service, Colorado Department of Public Health and Environment, University of Rochester Medicine, University of Rochester, Johns Hopkins University, Minnesota Department of Health, Connecticut Department of Public Health, Emory University, Vanderbilt University, Oregon Health & Science University
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: GEORGIA EMERGING INFECTIONS PROGRAM 2012, THE CONNECTICUT EMERGING INFECTIONS PROGRAM, EMERGING INFECTIONS PROGRAMS-ENHANCING EFFORTS TO PREVENT, CONTROL, AND MONITOR T, EMERGING INFECTIONS PROGRAM, CALIFORNIA EMERGING INFECTIONS PROGRAM, OREGON EMERGING INFECTIONS PROGRAM, EMERGING INFECTIONS PROGRAM-NEW YORK STATE, EMERGING INFECTIONS PROGRAM, MARYLAND EMERGING INFECTIONS PROGRAM
OpenAlex ID: W2885972935