Skip to main content Accessibility help
×
Home

Length of stay and odds of MRSA acquisition: a dose–response relationship?

  • H. Y. Loke (a1), W. M. Kyaw (a1), M. I. C. Chen (a2), J. W. Lim (a1), B. Ang (a3) and A. Chow (a1)...

Abstract

The association between methicillin-resistant Staphylococcus aureus (MRSA) colonisation and/or infection with increased morbidity and mortality among hospital patients has long been recognised. We sought to build on previous studies to identify modifiable risk factors associated with the acquisition of MRSA colonisation and infection by conducting a retrospective cohort study on patients admitted through the Emergency Department of an acute tertiary-care general hospital in Singapore which implemented universal on-admission MRSA screening. Patients were assigned to the acquisition or non-acquisition group depending on whether they acquired MRSA during their admission. We used logistic regression models with a patient being in the acquisition group as the binary outcome to identify factors associated with MRSA acquisition. A total of 1302 acquisition and 37 949 non-acquisition group patients were analysed. Fifteen variables were included in the multivariate model. A dose–response relationship between length of stay and odds of MRSA acquisition was observed, with a length of stay 3 weeks or more (Adj OR 11.78–57.36, all P < 0.001) being the single biggest predictor of MRSA acquisition. Other variables significantly associated with MRSA acquisition were: male gender, age 65 or greater, previous MRSA colonisation or infection, exposure to certain antibiotics and surgery, and history of diabetes.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Length of stay and odds of MRSA acquisition: a dose–response relationship?
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Length of stay and odds of MRSA acquisition: a dose–response relationship?
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Length of stay and odds of MRSA acquisition: a dose–response relationship?
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Author for correspondence: Win Mar Kyaw, E-mail: mar_kyaw_win@ttsh.com.sg

References

Hide All
1.Cosgrove, SE et al. (2003) Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clinical Infectious Diseases 36, 5359.
2.Huang, SS and Platt, R (2003) Risk of methicillin-resistant Staphylococcus aureus infection after previous infection or colonization. Clinical Infectious Diseases 36, 281285.
3.Merrer, J et al. (2000) ‘Colonization pressure’ and risk of acquisition of methicillin-resistant Staphylococcus aureus in a medical intensive care unit. Infection Control & Hospital Epidemiology 21, 718723.
4.Wong, JG et al. (2016) Length of stay an important mediator of hospital-acquired methicillin-resistant Staphylococcus aureus. Epidemiology and Infection 144, 12481256.
5.Muller, A (2006) Effect of individual- and group-level antibiotic exposure on MRSA isolation: a multilevel analysis. Journal of Antimicrobial Chemotherapy 58, 878881.
6.Warren, DK et al. (2004) Detection of methicillin-resistant Staphylococcus aureus directly from nasal swab specimens by a real-time PCR assay. Journal of Clinical Microbiology 42, 55785581.
7.Rossney, AS et al. (2008) Evaluation of the Xpert methicillin-resistant Staphylococcus aureus (MRSA) assay using the GeneXpert real-time PCR platform for rapid detection of MRSA from screening specimens. Journal of Clinical Microbiology 46, 32853290.
8.Kyaw, W et al. (2016) Screening of methicillin-resistant Staphylococcus aureus (MRSA) carriage: PCR versus culture. Singapore Health & Biomedical Congress. Singapore.
9.Kupfer, M et al. (2010) MRSA in a large German university hospital: male gender is a significant risk factor for MRSA acquisition. GMS Krankenhaushygiene Interdisziplinär 5, Doc11.
10.van Velzen, EVH et al. (2011) A retrospective cohort study into acquisition of MRSA and associated risk factors after implementation of universal screening in Scottish hospitals. Infection Control & Hospital Epidemiology 32, 889896.
11.Salangsang, JM et al. (2010) Patient-associated risk factors for acquisition of methicillin-resistant Staphylococcus aureus in a tertiary care hospital. Infection Control & Hospital Epidemiology 31, 11391147.
12.MRSA Screening Pathfinder Implementation Study Reports (2011) Available at https://www.hps.scot.nhs.uk/haiic/sshaip/resourcedetail.aspx?id=521 (Accessed 26 January 2019).
13.Weber, SG et al. (2003) Fluoroquinolones and the risk for methicillin-resistant Staphylococcus aureus in hospitalized patients1. Emerging Infectious Diseases 9, 14151422.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed