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MRSA linked to higher mortality rates in U.S. hospitals
Comorbid conditions are common among patients with MRSA and can further increase the risk for mortality.
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Methicillin-resistant Staphylococcus aureus is common in many rural and community hospitals and is associated with increased mortality rates, according to data from a new study presented at the 17th Annual Scientific Sessions of the Society for Healthcare Epidemiology of America, held recently in Baltimore.
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Despite the pervasiveness of MRSA infections, the study’s findings indicated that the majority of these infections seen among patients in rural and community hospitals are non-nosocomial. The results showed that 70.6% of the infections were non-nosocomial; 16.4% were nosocomial.
Further findings from the study demonstrated that comorbid conditions — including diabetes, chronic obstructive pulmonary disease and decubitus ulcers — are common among patients with MRSA and can further increase the risk for mortality.
Community hospitals
The researchers took cultures from patients with MRSA in 24 community hospitals between December 1999 and April 2006.
During the course of the study period, 10,766 episodes of infection or colonization due to MRSA were identified. Cultures obtained from the nares and from stool were excluded; the researchers said this allowed the analysis to examine only clinically important anatomic sites.
After these exclusions, 7,447 episodes were classified as MRSA infections.
The study’s results showed that patients with MRSA infection had a mean age of 62.5. The majority of patients with an MRSA infection (63.2%) were admitted from home; 1,765 patients (23.6%) were admitted from a nursing home or convalescent facility; and only 2.4% of patients were transferred from another hospital.
Only 697 (9.3%) of the patients had been admitted to a hospital during the prior three months.
The most common sites of infection were pulmonary (24.4%), urinary tract (13.1%), and the bloodstream (13%).
Follow-up data showed that major health consequences were not uncommon among patients with MRSA. About one-fifth of the patients with MRSA infections required treatment in an ICU, and 13.9% of the patients died or were transferred to hospice care prior to discharge from the hospital.
Fighting MRSA
Keith S. Kaye, MD, MPH, associate professor of medicine and medical director of the hospital infection control committee at Duke University Medical Center in Durham, N.C., and one of the study’s researchers, said some hospitals were more successful than others at fighting MRSA.
“Attention to hand hygiene, appropriate use of contact isolation and, in outbreak settings, using active surveillance were strategies that helped reduce the spread of MRSA,” Kaye told Infectious Disease News.
Comorbid conditions were common among patients with MRSA. These conditions included diabetes (39%), chronic obstructive pulmonary disease (23.3%), and the presence of decubitus ulcer (15.4%).
Kaye said the extent of the increase in risk for comorbid conditions among patients with MRSA was an important and somewhat surprising finding.
“This is one of the biggest findings from our study,” Kaye said. “Patients who develop MRSA infections are sick, often with advanced comorbid conditions and the need for assistance with activities of daily life.” – by Jay Lewis
For more information:
- Varkey J, Anderson D, Sexton D, et al. Epidemiology and outcomes of methicillin-resistant Staphylococcus aureus infections in a large, multicenter cohort of community hospitals. Presented at: The 17th Annual Scientific Sessions of the Society for Healthcare Epidemiology of America. April 14-17, 2007; Baltimore.