The Burden of Staphylococcus aureus Infections to Varying Types of U.S. Hospitals: An Analysis of the 2000 and 2001 Nationwide Inpatient Sample Database

Autor: Gary A. Noskin, E. Lapetina, M. Smulders, E. Cascade, E. Gemmen, Robert J. Rubin, Jan Kluytmans, E. Hedblom
Rok vydání: 2004
Předmět:
Zdroj: American Journal of Infection Control. 32:E105-E106
ISSN: 0196-6553
DOI: 10.1016/j.ajic.2004.04.157
Popis: BACKGROUND: Previous studies have investigated characteristics of patients who develop S. aureus infections; however, to date no study has attempted to relate hospital characteristics—including size, location, and facility type—to S. aureus infection incidence. METHODS: This study analyzed the 2000 and 2001 Nationwide Inpatient Sample (NIS) database. Approach and methodology were validated by a clinical panel. Logistic regression was used to calculate the relation between hospital characteristics and S. aureus infections, while controlling for variations in patient age, gender, race, insurer, and co-morbidities including burns. The analysis was restricted to invasive cardiovascular, orthopedic, or neurosurgical procedure stays that potentially carry higher risk of S. aureus infection. The study did not distinguish between methicillin-susceptible and methicillin-resistant infections. RESULTS: S. aureus infection was reported as a discharge diagnosis in 0.8% of all invasive stays in 2000–2001. The strongest hospital-specific predictor of S. aureus infection incidence was geographic location. Hospitals in the West (defined by U.S. census regions), Northeast, and South were slightly more likely to have patients with S. aureus infections than hospitals in the Midwest (OR=1.49, 1.32, 1.07, respectively). Hospitals located in urban areas were associated with a slightly greater risk of S. aureus infection compared to hospitals located in rural areas (OR=1.24; 95% CI=1.17–1.31). Larger hospitals were associated with a slightly greater incidence of S. aureus infection than smaller hospitals (OR=1.17; CI=1.12–1.22). Teaching hospitals were associated with a slightly greater incidence of S. aureus infections than non-teaching facilities (OR=1.05; CI=1.02–1.08). CONCLUSIONS: The results indicate that S. aureus infections are relatively more likely to occur in large, teaching hospitals located in urban areas in the West and Northeast of the U.S. It is important to note that the database analysis does not allow for differentiating between community-acquired versus hospital-acquired infections. Incidence rates of S. aureus infection are driven both by the presence of S. aureus in the underlying patient population of the hospital as well as by the hospital's infection control measures.
Databáze: OpenAIRE
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