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Prediction model identified patients at high risk for MRSA in VA hospitals
BALTIMORE — A two-step prediction model that included methicillin-resistant Staphylococcus aureus history and functional health status identified high risk patients for single occupancy rooms and preemptive contact isolation, according to a presenter here.
“Because this study was conducted within the surgical population at the VA, the model may need to be validated in other hospital units,” Katelyn Klein, MPH, infection prevention and control professional of Meriter Hospital in Madison, Wis., said during a presentation. “We predict the model will be generalizable to other units because the patient population at the VA is relatively homogeneous compared to other health care facilities.”
Patients are often admitted in the hospital before results of MRSA status is known. For this reason, Klein and colleagues developed a prediction model to supplement MRSA screening practices, improve admission processes and ultimately reduce opportunities for MRSA transmission in a VA hospital population.
The retrospective case control study included 181 surgical patients admitted between June 2009 and May 2010. The researchers compared electronic medical health records of 60 randomly selected MRSA-positive patients with 121 randomly selected MRSA-negative controls.
Of 28 variables examined, 10 were statistically significant risk factors for MRSA colonization upon admission (P<0.2). Further analysis excluded all but two: MRSA history and functional health status.
A two-question staged approach to the prediction model was then based upon these two variables to identify patients at high risk for MRSA. Patients were asked about previous history of MRSA colonization and whether or not they were ambulatory. Klein said 41 out of 60 cases “were identified right away after asking the first question (OR=80.8); the second question allowed for 46 of 60 cases (OR=6.54) to be identified.”
“We want to introduce this model as a quality improvement project hospital-wide, and we will need to continue surveillance of MRSA rates to see if there is an observable reduction in hospital acquired MRSA,” she said. – by Ashley DeNyse
For more information:
- Klein K. #1302. Presented at: the Association for Professionals in Infection Control and Epidemiology’s (APIC) 38th Annual Educational Conference and International Meeting; June 27-29; Baltimore.
Disclosure: Klein reports no relevant financial disclosures.
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