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MRSA infections increased risk for death after discharge
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Patients with MRSA health care-associated infections have an increased risk for long-term postdischarge mortality, according to data published in the American Journal of Infection Control.
“The take-home message is that health care-associated MRSA infections have lasting detrimental effects on patients that extend beyond the initial hospital stay,” Richard Nelson, PhD, of the IDEAS Center at the Veterans Affairs Salt Lake City Healthcare System and the University of Utah School of Medicine, told Infectious Disease News. “Even after discharge, there is still an elevated risk of mortality and this should be an important consideration for the postdischarge care of these patients in the outpatient setting.”
Richard Nelson
Nelson and colleagues evaluated the long-term effects of MRSA health care-associated infections (HAIs) by conducting a retrospective cohort study of patients hospitalized at 123 VA acute care facilities from October 2007 to September 2010. The patients were followed after discharge until death or 365 days. The researchers also evaluated a propensity score matched subsample of patients.
The cohort included 369,743 patients, including 3,599 with a positive MRSA culture, an incidence of 0.83 infections per 1,000 patient-days at risk. The propensity score matched sample included 3,592 patients with MRSA and 3,592 matched patients without MRSA. In the entire cohort, a multivariable model indicated patients with MRSA were more likely to die than those without MRSA (HR=1.42; 95% CI, 1.32-1.53). Patients with MRSA HAIs were 49% more likely to die than non-MRSA patients. Patients with MRSA colonization were 41% more likely to die.
In the propensity score-matched sample, the estimates were similar. Positive MRSA cultures increased the adjusted risk for death by 35%, and MRSA HAIs increased the risk by 46%.
“These results provide further evidence to support what we already know: health care-associated MRSA infections are bad,” Nelson said. “The hope is for these results to reinforce the importance of following the necessary measures to prevent these infections, as well as to make clinicians aware of the increased health care needs of these patients after discharge.”
Nelson said these results have led to investigations into whether other pathogens have similar effects. He also said that further investigations are needed to determine if the increased mortality related to MRSA infections is due to reinfection or due to complications from the initial infection. – by Emily Shafer
Disclosure: The researchers report no relevant financial disclosures.
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