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Methicillin-resistant Staphylococcus aureus (MRSA) nares colonization at hospital admission and its effect on subsequent MRSA infection.
Clin Infect Dis 2004; 39(6):776-82CI

Abstract

BACKGROUND

Asymptomatic colonization with methicillin-resistant Staphylococcus aureus (MRSA) has been described as a risk factor for subsequent MRSA infection. MRSA is an important nosocomial pathogen but has currently been reported in patients without typical risk factors for nosocomial acquisition. This study was designed to evaluate the impact of asymptomatic nares MRSA colonization on the development of subsequent MRSA infection. The incidence of MRSA infection was examined in patients with and patients without MRSA or methicillin-susceptible S. aureus (MSSA) colonization at admission to the hospital and in those who developed colonization during hospitalization.

METHODS

Patients admitted to 5 representative hospital units were prospectively evaluated. Nares samples were obtained for culture at admission and during hospitalization. Laboratory culture results were monitored to identify all MRSA infections that occurred during the study period and 1 year thereafter.

RESULTS

Of the 758 patients who had cultures of nares samples performed at admission, 3.4% were colonized with MRSA, and 21% were colonized with MSSA. A total of 19% of patients with MRSA colonization at admission and 25% who acquired MRSA colonization during hospitalization developed infection with MRSA, compared with 1.5% and 2.0% of patients colonized with MSSA (P<.01) and uncolonized (P<.01), respectively, at admission. MRSA colonization at admission increased the risk of subsequent MRSA infection, compared with MSSA colonization (relative risk [RR], 13; 95% confidence interval [CI], 2.7-64) or no staphylococcal colonization (RR, 9.5; 95% CI, 3.6-25) at admission. Acquisition of MRSA colonization also increased the risk for subsequent MRSA infection, compared with no acquisition (RR, 12; 95% CI, 4.0-38).

CONCLUSION

MRSA colonization of nares, either present at admission to the hospital or acquired during hospitalization, increases the risk for MRSA infection. Identifying MRSA colonization at admission could target a high-risk population that may benefit from interventions to decrease the risk for subsequent MRSA infection.

Authors+Show Affiliations

Infectious Disease Service, Brooke Army Medical Center, Ft. Sam Houston, Texas 78234-6000, USA. kepler.davis@amedd.army.milNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15472807

Citation

Davis, Kepler A., et al. "Methicillin-resistant Staphylococcus Aureus (MRSA) Nares Colonization at Hospital Admission and Its Effect On Subsequent MRSA Infection." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 39, no. 6, 2004, pp. 776-82.
Davis KA, Stewart JJ, Crouch HK, et al. Methicillin-resistant Staphylococcus aureus (MRSA) nares colonization at hospital admission and its effect on subsequent MRSA infection. Clin Infect Dis. 2004;39(6):776-82.
Davis, K. A., Stewart, J. J., Crouch, H. K., Florez, C. E., & Hospenthal, D. R. (2004). Methicillin-resistant Staphylococcus aureus (MRSA) nares colonization at hospital admission and its effect on subsequent MRSA infection. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 39(6), pp. 776-82.
Davis KA, et al. Methicillin-resistant Staphylococcus Aureus (MRSA) Nares Colonization at Hospital Admission and Its Effect On Subsequent MRSA Infection. Clin Infect Dis. 2004 Sep 15;39(6):776-82. PubMed PMID: 15472807.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Methicillin-resistant Staphylococcus aureus (MRSA) nares colonization at hospital admission and its effect on subsequent MRSA infection. AU - Davis,Kepler A, AU - Stewart,Justin J, AU - Crouch,Helen K, AU - Florez,Christopher E, AU - Hospenthal,Duane R, Y1 - 2004/08/27/ PY - 2003/12/31/received PY - 2004/04/14/accepted PY - 2004/10/9/pubmed PY - 2005/12/24/medline PY - 2004/10/9/entrez SP - 776 EP - 82 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 39 IS - 6 N2 - BACKGROUND: Asymptomatic colonization with methicillin-resistant Staphylococcus aureus (MRSA) has been described as a risk factor for subsequent MRSA infection. MRSA is an important nosocomial pathogen but has currently been reported in patients without typical risk factors for nosocomial acquisition. This study was designed to evaluate the impact of asymptomatic nares MRSA colonization on the development of subsequent MRSA infection. The incidence of MRSA infection was examined in patients with and patients without MRSA or methicillin-susceptible S. aureus (MSSA) colonization at admission to the hospital and in those who developed colonization during hospitalization. METHODS: Patients admitted to 5 representative hospital units were prospectively evaluated. Nares samples were obtained for culture at admission and during hospitalization. Laboratory culture results were monitored to identify all MRSA infections that occurred during the study period and 1 year thereafter. RESULTS: Of the 758 patients who had cultures of nares samples performed at admission, 3.4% were colonized with MRSA, and 21% were colonized with MSSA. A total of 19% of patients with MRSA colonization at admission and 25% who acquired MRSA colonization during hospitalization developed infection with MRSA, compared with 1.5% and 2.0% of patients colonized with MSSA (P<.01) and uncolonized (P<.01), respectively, at admission. MRSA colonization at admission increased the risk of subsequent MRSA infection, compared with MSSA colonization (relative risk [RR], 13; 95% confidence interval [CI], 2.7-64) or no staphylococcal colonization (RR, 9.5; 95% CI, 3.6-25) at admission. Acquisition of MRSA colonization also increased the risk for subsequent MRSA infection, compared with no acquisition (RR, 12; 95% CI, 4.0-38). CONCLUSION: MRSA colonization of nares, either present at admission to the hospital or acquired during hospitalization, increases the risk for MRSA infection. Identifying MRSA colonization at admission could target a high-risk population that may benefit from interventions to decrease the risk for subsequent MRSA infection. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/15472807/Methicillin_resistant_Staphylococcus_aureus__MRSA__nares_colonization_at_hospital_admission_and_its_effect_on_subsequent_MRSA_infection_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/422997 DB - PRIME DP - Unbound Medicine ER -