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What Is Nosocomial? Large Variation in Hospital Choice of Numerators and Denominators Affects Rates of Hospital-Onset Methicillin-Resistant Staphylococcus aureus

Published online by Cambridge University Press:  02 January 2015

Rupak Datta*
Affiliation:
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California
Melissa Kuo King
Affiliation:
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California
Diane Kim
Affiliation:
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California
Christopher Nguyen
Affiliation:
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California
Kristen Elkins
Affiliation:
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California
Adrijana Gombosev
Affiliation:
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California
Taliser R. Avery
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts
Hildy Meyers
Affiliation:
Epidemiology and Assessment, Orange County Health Care Agency, Santa Ana, California
Michele Cheung
Affiliation:
Epidemiology and Assessment, Orange County Health Care Agency, Santa Ana, California
Susan S. Huang
Affiliation:
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
*
University of California Irvine School of Medicine, Health Policy Research Institute, 100 Theory, Suite 110, Irvine, CA 92697 (rdatta@uci.edu)

Abstract

We calculated hospital-onset methicillin-resistant Staphylococcus aureus (HO-MRSA) rates for Orange County, California, hospitals using survey and state data. Numerators were variably defined as HO-MRSA occurring more than 48 hours (37%), more than 2 days (30%), and more than 3 days (33%) postadmission. Survey-reported denominators differed from state-reported patient-days. Numerator and denominator choices substantially impacted HO-MRSA rates.

Type
Concise Communication
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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