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Methicillin-Resistant Staphylococcus aureus (MRSA): Risk and Outcome of Colonized vs. Infected Patients

Published online by Cambridge University Press:  02 January 2015

Jenice N. Longfield ,
Timothy R. Townsend ,
David F. Cruess ,
Maureen Stephens ,
Catherine Bishop ,
Elizabeth Bolyard  and
Elsie Hutchinson
Jenice N. Longfield*
Affiliation:
Hospital Epidemiology Unit, The Johns Hopkins Hospital, Baltimore, Maryland and the Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Timothy R. Townsend
Affiliation:
Hospital Epidemiology Unit, The Johns Hopkins Hospital, Baltimore, Maryland and the Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
David F. Cruess
Affiliation:
Hospital Epidemiology Unit, The Johns Hopkins Hospital, Baltimore, Maryland and the Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Maureen Stephens
Affiliation:
Hospital Epidemiology Unit, The Johns Hopkins Hospital, Baltimore, Maryland and the Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Catherine Bishop
Affiliation:
Hospital Epidemiology Unit, The Johns Hopkins Hospital, Baltimore, Maryland and the Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Elizabeth Bolyard
Affiliation:
Hospital Epidemiology Unit, The Johns Hopkins Hospital, Baltimore, Maryland and the Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Elsie Hutchinson
Affiliation:
Hospital Epidemiology Unit, The Johns Hopkins Hospital, Baltimore, Maryland and the Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
*
Department of Preventive Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4799
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Abstract

A retrospective study of 204 patients culture positive for methicillin-resistant Staphylococcus aureus compared infected and colonized patients. Seventy-eight patients were colonized and never developed infection (C), 24 were colonized and subsequently infected (C➧I), and 102 patients had 1 or more nosocomial infections with MRSA at time of first culture (I). The most prevalent sites of infection were wound (26.5%) and bloodstream (20.7%), whereas the respiratory tract and surgical wounds were both frequent sites of colonization. Stepwise discriminant analysis found the most important factors in differentiating likelihood of colonization vs. infection were recent prior hospitalization, history of wound debridement, and number of invasive procedures. Ten percent of (C) died and 25.5% of (I) died. MRSA contributed to death in 57.6% of the (I) deaths (p<.05). These results underscore the importance of differentiating (C) vs. (I) in hospitals where MRSA is endemic so that early specific treatment may be initiated. Risk factors for infection should be discriminated from those for acquisition of the organism.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 6 , Issue 11 , November 1985 , pp. 445 - 450
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1985

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