A retrospective cohort study into acquisition of MRSA and associated risk factors after implementation of universal screening in Scottish hospitals
| Autor: | G. F. S. Edwards, F. M. MacKenzie, Jacqui Reilly, A. Leanord, E. van Velzen, I. M. Gould, Kimberley Kavanagh, E. K. Girvan, Robert G. Masterton |
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| Rok vydání: | 2011 |
| Předmět: |
Microbiology (medical)
Male Methicillin-Resistant Staphylococcus aureus medicine.medical_specialty Pediatrics Epidemiology Specialty Patient Admission Internal medicine medicine Humans Mass Screening Renal Insufficiency Admission screening Genotyping Mass screening Aged Retrospective Studies Aged 80 and over Cross Infection business.industry Age Factors Retrospective cohort study Middle Aged Staphylococcal Infections Confidence interval Hospitals Patient Discharge Infectious Diseases Scotland Cohort Wounds and Injuries Female Self Report business |
| Zdroj: | Infection control and hospital epidemiology. 32(9) |
| ISSN: | 1559-6834 0195-9417 |
| Popis: | Objective.To estimate the proportion of patients who acquire methicillin-resistantStaphylococcus aureus(MRSA) while in hospital and to identify risk factors associated with acquisition of MRSA.Design.Retrospective cohort study.Patients.Adult patients discharged from 36 general specialty wards of 2 Scottish hospitals that had implemented universal screening for MRSA on admission.Methods.Patients were screened for MRSA on discharge from hospital by using multisite body swabs that were tested by culture. Discharge screening results were linked to admission screening results. Genotyping was undertaken to identify newly acquired MRSA in MRSA-positive patients on admission.Results.Of the 5,155 patients screened for MRSA on discharge, 2.9% (95% confidence interval [CI], 2.43–3.34) were found to be positive. In the subcohort screened on both admission and discharge (n= 2,724), 1.3% of all patients acquired MRSA while in hospital (incidence rate, 2.1/1,000 hospital bed-days in this cohort [95% CI, 1.5–2.9]), while 1.3% remained MRSA positive throughout hospital stay. Three risk factors for acquisition of MRSA were identified: age above 64 years, self-reported renal failure, and self-reported presence of open wounds. On a population level, the prevalence of MRSA colonization did not differ between admission and discharge.Conclusions.Cross-transmission of MRSA takes place in Scottish hospitals that have implemented universal screening for MRSA. This study reinforces the importance of infection prevention and control measures to prevent MRSA cross-transmission in hospitals; universal screening for MRSA on admission will in itself not be sufficient to reduce the number of MRSA colonizations and subsequent MRSA infections. |
| Databáze: | OpenAIRE |
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