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MRSA infections decline in hospitals, persist in community
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Infections caused by USA300, the most common strain of MRSA, have declined in hospitals but persisted in the community, according to recent study data.
Additionally, illicit drug use remained a significant risk factor for community- and hospital-onset MRSA bloodstream infections (BSIs).
“Our findings suggest that USA300 MRSA is now endemic within both community and hospital settings,” Kyle J. Popovich, MD, MS, assistant professor of infectious disease at Rush University Medical Center, and colleagues wrote of their retrospective, observational study. “Despite overall decreases in hospital-onset MRSA infections, for 4 years of the study period, the proportion of hospital-onset MRSA bloodstream infections due to USA300 was greater than 60%.”
Kyle J. Popovich
Popovich and colleagues used electronic surveillance data from January 2007 through December 2013 from a Chicago safety net hospital to identify cases of Staphylococcus aureus BSIs. In addition, the researchers evaluated changes in BSI incidence over time and gathered risk factor data through medical chart review.
The researchers found that 36% of 1,015 S. aureus cases were caused by MRSA and that hospital-onset (HO) MRSA BSIs decreased while community-onset (CO) MRSA BSIs remained the same. The rate of both CO– and HO–methicillin-susceptible S. aureus infections decreased after 2010. Popovich and colleagues also reported that more than 50% of HO-MRSA BSIs were caused by the USA300 strain, and for 4 years, the strain was responsible for more than 60% of those infections. In addition, the investigators found that drug use significantly increased the risks for CO-MRSA BSIs (adjusted OR = 3.46; 95% CI, 1.54-7.78) or HO-MRSA BSIs (aOR = 2.7; 95% CI, 1.14-6.38) caused by the USA300 strains.
“Enhanced prevention efforts in the community for certain populations, such as those engaging in illicit drug use, may be necessary to further curb the spread of invasive MRSA infections,” Popovich and colleagues wrote. – by Will Offit
Disclosure: The researchers report no relevant financial disclosures.
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