Hospital- and Community-Based Surveillance of Methicillin-Resistant Staphylococcus aureus: Previous Hospitalization is the Major Risk Factor

Abstract

These findings demonstrate that the incidence of MRSA is higher than previously reported and that hospital contact is the single most important risk factor for the acquisition of MRSA in our community. Screening for MRSA in previously hospitalized patients at the time of hospitalization may reduce nosocomial spread and indirectly reduce the incidence of MRSA in the community.

Length of exposure to the hospital environment is more important than antibiotic exposure in healthcare associated infections by methicillin-resistant Staphylococcus aureus: a comparative study

“…These two factors, especially the former, are, without any doubt, among the strongest predictors of MRSA infections in older and newer studies. 4,[9][10][11][12][13][14][15][16][17][18][20][21][22][23][25][26][27][28]33,34 Obviously, differences in our results compared to the above-described studies may be partly due to different study design and differences in populations studied, as noted in a recent meta-analysis. 38 Additionally, from a subanalysis of the blood isolates of our study groups, the mean number of antibiotic-days did emerge as independent predictor of a subsequent HCA-MRSA bacteremia.…”

“…4,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Both total antimicrobial use as well as specific antimicrobial classes have been implicated. [11][12][13][14][15][16][17][18]24,25 Included in these classes are β-lactamic antibiotics, 14,26-33 cephalosporins, 11,12,16,22,29 aminoglycosides, 22,33,34 macrolides, 27 glycopeptides 15,[27][28][29]34 and fluoroquinolones (FQs). 6,11,12,14,[26][27][28][29][35][36][37] A relatively recently published meta-analysis detected a clear association between exposure to antibiotics and MRSA isolation.…”

“…[4][5][6][7][8] Risk factors for healthcare-associated MRSA acquisition and infection include age, duration of hospitalization, underlying disease, neonatal or adult ICU or burn unit location, invasive procedures or devices, previous hospitalization, intensity of care, number of inter-ward transfers, coma, low physical function, serum albumin, pressure sores, immunosuppression, proximity to a MRSA-colonized patient, underlying dermatological disease, enteral feedings. 4,[9][10][11][12][13][14][15][16][17][18] The issue of antibiotic use as a risk factor is complex and still not completely clarified in full detail. Administration of multiple antibiotics and multiple courses of antibiotics were a…”

Outbreak of Gram-positive bacterial keratitis associated with epidemic keratoconjunctivitis in neonates and infants

“…[10][11][12] Colonization of MRSA has been found in 1.5% of the general population, but it increased to 9.4% when the patients were exposed to a healthcare facility. 13,14 Consequently, about 85% of MRSA infections are health care associated. 15 Because 88% of our patients who showed bacterial keratitis were involved with HCU stay, it was expected that MRSA could be a common pathogen in our patients.…”

Methicillin-resistant <italic>Staphylococcus aureus</italic> in First Nations communities in Canada

“…By 1999, just over 5% of S aureus strains isolated from hospitalized patients in Canada were methicillin-resistant (4). The corresponding rate for isolates from American hospitals was 35% (5,6). Prevention of transmission of MRSA in hospitals has focused on infection-control practices and surveillance (6)(7)(8).…”