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Epidemiology of Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococcus in a Rural State

Published online by Cambridge University Press:  21 June 2016

Philip M. Polgreen ,
Susan E. Beekmann ,
Yi Yi Chen ,
Gary V. Doern ,
Michael A. Pfaller ,
Angela B. Brueggemann ,
Loreen A. Herwaldt  and
Daniel J. Diekema
Philip M. Polgreen
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Iowa City, Iowa
Susan E. Beekmann
Affiliation:
Division of Medical Microbiology, Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, Iowa
Yi Yi Chen
Affiliation:
Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa
Gary V. Doern
Affiliation:
Division of Medical Microbiology, Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, Iowa
Michael A. Pfaller
Affiliation:
Division of Medical Microbiology, Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, Iowa Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
Angela B. Brueggemann
Affiliation:
Division of Medical Microbiology, Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, Iowa Department of Public Health and Primary Care, University of Oxford, Oxford, United Kingdom
Loreen A. Herwaldt
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Iowa City, Iowa Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa Program of Hospital Epidemiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Daniel J. Diekema*
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Iowa City, Iowa Division of Medical Microbiology, Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, Iowa Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
*
C 606 General Hospital, University of Iowa Hospital, 200 Hawkins Drive, Iowa City, Iowa 52246 (daniel-diekema@uiowa.edu)
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Abstract

Background.

Most data on methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) isolates come from large tertiary care centers. Infection control personnel need to understand the epidemiology of MRSA and VRE across the continuum of care, including small rural hospitals, to develop effective control strategies.

Objective.

To describe the epidemiology of MRSA and VRE in Iowa.

Setting.

Fifteen hospitals in Iowa.

Methods.

Between July 1998 and June 2001, a total of 1,968 S. aureus isolates and 1,845 Enterococcus isolates from patients infected with these pathogens were examined. Multivariate models were developed to evaluate patient and institutional risk factors for MRSA infection and VRE infection.

Results.

The proportion of S. aureus isolates resistant to methicillin was 31%, and the proportion of Enterococcus isolates resistant to vancomycin was 6%. Independent risk factors for MRSA infection included residence in a long-term care facility, age of more than 60 years, hospitalization in a hospital with less than 200 short-term care beds, and acquiring the infection in the hospital. Independent risk factors for VRE infection included use of a central venous catheter, residence in a long-term care facility, acquisition of infection in the hospital, and hospitalization in a hospital with more than 200 short-term care beds.

Conclusions.

In Iowa, the epidemiology of MRSA differ from those of VRE. MRSA has become established in small rural hospitals. Effective MRSA control strategies may require inclusion of all hospitals in a state or region.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 3 , March 2006 , pp. 252 - 256
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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