Epidemiology and Infection

Original Papers

MRSA and HAI

Post-discharge mortality in patients hospitalized with MRSA infection and/or colonization

A. SHARMAa1a2, C. ROGERSa1, D. RIMLANDa1a3, C. STAFFORDa1, S. SATOLAa1a3, E. CRISPELLa1a3 and R. GAYNESa1a3 c1

a1 Atlanta Veterans Affairs Medical Center, Decatur, GA, USA

a2 Department of Epidemiology, Emory University Laney Graduate School, Atlanta, GA, USA

a3 Emory University School of Medicine, Atlanta, GA, USA

SUMMARY

Methicillin-resistant Staphylococcus aureus (MRSA) infection is known to increase in-hospital mortality, but little is known about its association with long-term health. Two hundred and thirty-seven deaths occurred among 707 patients with MRSA infection at the time of hospitalization and/or nasal colonization followed for almost 4 years after discharge from the Atlanta Veterans Affairs Medical Center, USA. The crude mortality rate in patients with an infection and colonization (23·57/100 person-years) was significantly higher than the rate in patients with only colonization (15·67/100 person-years, P = 0·037). MRSA infection, hospitalization within past 6 months, and histories of cancer or haemodialysis were independent risk factors. Adjusted mortality rates in patients with infection were almost twice as high compared to patients who were only colonized: patients infected and colonized [hazard ratio (HR) 1·93, 95% confidence interval (CI) 1·31–2·84]; patients infected but not colonized (HR 1·96, 95% CI 1·22–3·17). Surviving MRSA infection adversely affects long-term mortality, underscoring the importance of infection control in healthcare settings.

(Received June 18 2012)

(Revised August 06 2012)

(Accepted August 07 2012)

(Online publication September 13 2012)

Key words

  • Epidemiology;
  • hygiene and hospital infections;
  • infectious disease control;
  • methicillin-resistant S. aureus (MRSA);
  • prevention

Correspondence

c1 Author for correspondence: Dr R. Gaynes, Atlanta Veterans Affairs Medical Center, 1670 Clairmont Road, Decatur, GA 30033, USA. (Email: robert.gaynes@va.gov)

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