Long-Term Risk for Readmission, Methicillin-resistant Staphylococcus aureus (MRSA) Infection, and Death among MRSA-Colonized Veterans.

Dec 2012

Quezada Joaquin NM, Diekema DJ, Perencevich EN, Bailey G, Winokur PL, Schweizer ML.

Source

Division of Infectious Diseases.

Abstract

Background: 

While numerous studies assessed outcomes of MRSA colonization over the short term, little is known about longer-term outcomes after discharge. An assessment of long-term outcomes could inform the utility of various MRSA prevention approaches.Methods: A matched cohort study was performed among Veterans Affairs (VA) patients screened for MRSA colonization between the years 2007 and 2009 and followed to evaluate outcomes until 2010. Cox proportional hazard models were used to evaluate the association between MRSA colonization and long-term outcomes such as infection-related readmission, and crude mortality.Results: 404 veterans were included, 206 of whom were MRSA carriers and 198 who were non-carriers. There were no culture-proven MRSA infections on readmission among the non-carriers, but 13% of MRSA-carriers were readmitted with culture proven MRSA infections on readmission  MRSA carriers were significantly more likely to be readmitted, be readmitted more than once due to proven or probable MRSA infections, and be readmitted within 90 days of discharge compared to non-carriers. Infection-related readmission (adjusted hazard ratio [AHR] =4.07; 95% confidence interval [CI]: 2.16, 7.67) and mortality (AHR=2.71; 95% CI: 1.87, 3.91) were significantly higher amongMRSA carriers compared to non-carriers, after statistically adjusting for potential confounders

Conclusions: 

Among a cohort of VA patients, MRSA carriers are at high risk of infection-related readmission, MRSA infection and mortality compared to non-carriers. Non- carriers are at very low risk of subsequent MRSA infection. Future studies should address whether interventions such as nasal or skin decolonization could result in improved outcomes for MRSA carriers.

Antimicrobial Agents and Chemotherapy

Methicillin-resistant Staphylococcus aureus (MRSA) in the Athlete.

Methicillin-resistant Staphylococcus aureus (MRSA) in the Athlete.

Int J Sports Med. 2009 Aug

D. E. RedziniakD. R. DiduchK. TurmanJ. HartT. L. GrindstaffJ. M. MacKnightD. J. Mistry

The Orthopedic and Sports Medicine Center, Department of Orthopedic Surgery, Annapolis 21409, USA. redziniak@verizon.net

Although once considered only a nosocomial pathogen, methicillin-resistant Staphylococcus aureus (MRSA) is a rapidly emerging, problematic infection in the community. Community acquired MRSA (CA-MRSA) is notably becoming more prevalent in athletic environments and unfortunately, can be easily transmitted via superficial abrasions and minor skin trauma. CA-MRSA infections are highly contagious and are associated with significant morbidity, with published reports of up to 70% of infected team members requiring hospitalization and intravenous antibiotics . Risk factors for athletic related environments include contact sports with repeated close physical contact with other competitors, open abrasions, and sharing of personal equipment. Failure to correctly diagnose and appropriately treat skin and soft tissue lesions infected with CA-MRSA may contribute to large scale MRSA infections in athletic environments. The purpose of this review article is to help sports medicine physicians prevent, identify, and treat MRSA skin and superficial soft tissue infections in athletic environments. Georg Thieme Verlag KG Stuttgart New York.

Thieme Connect

What you need to know about MRSA

What you need to know about MRSA

Get Schooled looks at MRSA.
October 29, 2007

Methicillin-resistant staphylococcus aureus, or MRSA, infections have been featured in several news stories lately, including reports of cases in local schools. As of Friday, 12 confirmed cases had been reported in schools, most of them linked to athletes. Statewide, the number is more than 40. Here is some information about MRSA and how to avoid getting or spreading infections.

Q: What is Methicillin-resistant staphylococcus aureus?

A: Staphylococcus aureus, called staph, is a common type of bacteria found on the skin and in the nose and lungs of healthy people. It acts as a hitchhiker most of the time, causing no harm, but if a person gets a cut or other wound, or an illness that weakens the lining of the lungs, an infection can occur. Most staph infections respond to penicillin and similar antibiotics. MRSA is resistant to penicillin and related antibiotics, so other drugs must be used to treat it.

Q: How do you get an MRSA infection?

A: Staph bacteria, including MRSA, are spread by close contact with infected people or the things they touch. The bacteria are not spread through the air.

Q: How many MRSA infection cases have been reported by local schools?

A: As of Oct. 26, six medically confirmed MRSA infections had been reported by local schools. Only one person was hospitalized. All those with infections are receiving, or have completed, treatment.

Q: What are local schools doing about it?

A: They are working with local health officials to educate teachers, coaches, athletic directors and students about staph infections. School custodians are cleaning locker rooms, weight rooms and other common athletic areas and shared athletic equipment, with hospital-grade disinfectants. Schools also are encouraging students to follow simple prevention measures.

Q: What can I do to prevent an infection?

A: Health officials say the best way to prevent infection is to wash your hands frequently; avoid sharing personal items such as towels, razors, sports equipment and make-up; and cover wounds. If a wound becomes red, painful or slow to heal, see a physician.

Q: Where can I get more information?

A: If you have questions about what your school is doing, or want to report a medically confirmed case of MRSA infection, contact your school administrator or nurse. For more information about MRSA, visit the Virginia Department of Health Web site, which contains information about the bacteria and infection prevention measures: Sources: Virginia Department of Health; Centers for Disease Control and Prevention. Get Schooled! Have an education question that you'd like us to explore? Send it to getschooled@dailypress.com or call 757-247-4668.

Newport News, Va., Daily Press