A retrospective cohort study into acquisition of MRSA and associated risk factors after implementation of universal screening in Scottish hospitals

E. V. H. van Velzen, J. S. Reilly, K. Kavanagh, A. Leanord, G. F. S. Edwards, E. K. Girvan, I. M. Gould, F. M. MacKenzie, R. Masterton

Research output: Contribution to journalArticle

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Abstract

To estimate the proportion of patients who acquire methicillin-resistant Staphylococcus aureus (MRSA) while in hospital and to identify risk factors associated with acquisition of MRSA. Retrospective cohort study. Adult patients discharged from 36 general specialty wards of 2 Scottish hospitals that had implemented universal screening for MRSA on admission. Patients were screened for MRSA on discharge from hospital by using multisite body swabs that were tested by culture. Discharge screening results were linked to admission screening results. Genotyping was undertaken to identify newly acquired MRSA in MRSA-positive patients on admission. Of the 5,155 patients screened for MRSA on discharge, 2.9% (95% confidence interval [CI], 2.43-3.34) were found to be positive. In the subcohort screened on both admission and discharge ([Formula: see text]), 1.3% of all patients acquired MRSA while in hospital (incidence rate, 2.1/1,000 hospital bed-days in this cohort [95% CI, 1.5-2.9]), while 1.3% remained MRSA positive throughout hospital stay. Three risk factors for acquisition of MRSA were identified: age above 64 years, self-reported renal failure, and self-reported presence of open wounds. On a population level, the prevalence of MRSA colonization did not differ between admission and discharge.
Cross-transmission of MRSA takes place in Scottish hospitals that have implemented universal screening for MRSA. This study reinforces the importance of infection prevention and control measures to prevent MRSA cross-transmission in hospitals; universal screening for MRSA on admission will in itself not be sufficient to reduce the number of MRSA colonizations and subsequent MRSA infections.

LanguageEnglish
Pages889-896
Number of pages8
JournalInfection Control and Hospital Epidemiology
Volume32
Issue number9
DOIs
Publication statusPublished - 2011

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Methicillin-Resistant Staphylococcus aureus
Cohort Studies
Retrospective Studies
Confidence Intervals
Patients' Rooms
Patient Admission
Infection Control
Renal Insufficiency

Keywords

  • MRSA
  • universal screening
  • hospitals
  • infection
  • mathematical analysis

Cite this

van Velzen, E. V. H. ; Reilly, J. S. ; Kavanagh, K. ; Leanord, A. ; Edwards, G. F. S. ; Girvan, E. K. ; Gould, I. M. ; MacKenzie, F. M. ; Masterton, R. / A retrospective cohort study into acquisition of MRSA and associated risk factors after implementation of universal screening in Scottish hospitals. In: Infection Control and Hospital Epidemiology. 2011 ; Vol. 32, No. 9. pp. 889-896.
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abstract = "To estimate the proportion of patients who acquire methicillin-resistant Staphylococcus aureus (MRSA) while in hospital and to identify risk factors associated with acquisition of MRSA. Retrospective cohort study. Adult patients discharged from 36 general specialty wards of 2 Scottish hospitals that had implemented universal screening for MRSA on admission. Patients were screened for MRSA on discharge from hospital by using multisite body swabs that were tested by culture. Discharge screening results were linked to admission screening results. Genotyping was undertaken to identify newly acquired MRSA in MRSA-positive patients on admission. Of the 5,155 patients screened for MRSA on discharge, 2.9{\%} (95{\%} confidence interval [CI], 2.43-3.34) were found to be positive. In the subcohort screened on both admission and discharge ([Formula: see text]), 1.3{\%} of all patients acquired MRSA while in hospital (incidence rate, 2.1/1,000 hospital bed-days in this cohort [95{\%} CI, 1.5-2.9]), while 1.3{\%} remained MRSA positive throughout hospital stay. Three risk factors for acquisition of MRSA were identified: age above 64 years, self-reported renal failure, and self-reported presence of open wounds. On a population level, the prevalence of MRSA colonization did not differ between admission and discharge.Cross-transmission of MRSA takes place in Scottish hospitals that have implemented universal screening for MRSA. This study reinforces the importance of infection prevention and control measures to prevent MRSA cross-transmission in hospitals; universal screening for MRSA on admission will in itself not be sufficient to reduce the number of MRSA colonizations and subsequent MRSA infections.",
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A retrospective cohort study into acquisition of MRSA and associated risk factors after implementation of universal screening in Scottish hospitals. / van Velzen, E. V. H.; Reilly, J. S.; Kavanagh, K.; Leanord, A.; Edwards, G. F. S.; Girvan, E. K.; Gould, I. M.; MacKenzie, F. M.; Masterton, R.

In: Infection Control and Hospital Epidemiology, Vol. 32, No. 9, 2011, p. 889-896.

Research output: Contribution to journalArticle

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T1 - A retrospective cohort study into acquisition of MRSA and associated risk factors after implementation of universal screening in Scottish hospitals

AU - van Velzen, E. V. H.

AU - Reilly, J. S.

AU - Kavanagh, K.

AU - Leanord, A.

AU - Edwards, G. F. S.

AU - Girvan, E. K.

AU - Gould, I. M.

AU - MacKenzie, F. M.

AU - Masterton, R.

PY - 2011

Y1 - 2011

N2 - To estimate the proportion of patients who acquire methicillin-resistant Staphylococcus aureus (MRSA) while in hospital and to identify risk factors associated with acquisition of MRSA. Retrospective cohort study. Adult patients discharged from 36 general specialty wards of 2 Scottish hospitals that had implemented universal screening for MRSA on admission. Patients were screened for MRSA on discharge from hospital by using multisite body swabs that were tested by culture. Discharge screening results were linked to admission screening results. Genotyping was undertaken to identify newly acquired MRSA in MRSA-positive patients on admission. Of the 5,155 patients screened for MRSA on discharge, 2.9% (95% confidence interval [CI], 2.43-3.34) were found to be positive. In the subcohort screened on both admission and discharge ([Formula: see text]), 1.3% of all patients acquired MRSA while in hospital (incidence rate, 2.1/1,000 hospital bed-days in this cohort [95% CI, 1.5-2.9]), while 1.3% remained MRSA positive throughout hospital stay. Three risk factors for acquisition of MRSA were identified: age above 64 years, self-reported renal failure, and self-reported presence of open wounds. On a population level, the prevalence of MRSA colonization did not differ between admission and discharge.Cross-transmission of MRSA takes place in Scottish hospitals that have implemented universal screening for MRSA. This study reinforces the importance of infection prevention and control measures to prevent MRSA cross-transmission in hospitals; universal screening for MRSA on admission will in itself not be sufficient to reduce the number of MRSA colonizations and subsequent MRSA infections.

AB - To estimate the proportion of patients who acquire methicillin-resistant Staphylococcus aureus (MRSA) while in hospital and to identify risk factors associated with acquisition of MRSA. Retrospective cohort study. Adult patients discharged from 36 general specialty wards of 2 Scottish hospitals that had implemented universal screening for MRSA on admission. Patients were screened for MRSA on discharge from hospital by using multisite body swabs that were tested by culture. Discharge screening results were linked to admission screening results. Genotyping was undertaken to identify newly acquired MRSA in MRSA-positive patients on admission. Of the 5,155 patients screened for MRSA on discharge, 2.9% (95% confidence interval [CI], 2.43-3.34) were found to be positive. In the subcohort screened on both admission and discharge ([Formula: see text]), 1.3% of all patients acquired MRSA while in hospital (incidence rate, 2.1/1,000 hospital bed-days in this cohort [95% CI, 1.5-2.9]), while 1.3% remained MRSA positive throughout hospital stay. Three risk factors for acquisition of MRSA were identified: age above 64 years, self-reported renal failure, and self-reported presence of open wounds. On a population level, the prevalence of MRSA colonization did not differ between admission and discharge.Cross-transmission of MRSA takes place in Scottish hospitals that have implemented universal screening for MRSA. This study reinforces the importance of infection prevention and control measures to prevent MRSA cross-transmission in hospitals; universal screening for MRSA on admission will in itself not be sufficient to reduce the number of MRSA colonizations and subsequent MRSA infections.

KW - MRSA

KW - universal screening

KW - hospitals

KW - infection

KW - mathematical analysis

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SN - 0899-823X

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