title: Post-discharge mortality in patients hospitalized with MRSA infection and/or colonization.
abstract: Methicillin-resistant Staphylococcus aureus (MRSA) infection is known to increase in-hospital mortality, but little is known about its association with long-term health. Two hundred and thirty-seven deaths occurred among 707 patients with MRSA infection at the time of hospitalization and/or nasal colonization followed for almost 4 years after discharge from the Atlanta Veterans Affairs Medical Center, USA. The crude mortality rate in patients with an infection and colonization (23·57/100 person-years) was significantly higher than the rate in patients with only colonization (15·67/100 person-years, P = 0·037). MRSA infection, hospitalization within past 6 months, and histories of cancer or haemodialysis were independent risk factors. Adjusted mortality rates in patients with infection were almost twice as high compared to patients who were only colonized: patients infected and colonized [hazard ratio (HR) 1·93, 95% confidence interval (CI) 1·31-2·84]; patients infected but not colonized (HR 1·96, 95% CI 1·22-3·17). Surviving MRSA infection adversely affects long-term mortality, underscoring the importance of infection control in healthcare settings.
authors.affiliation: Atlanta Veterans Affairs Medical Center, Decatur, GA 30033, USA.
authors.forename: A
authors.initials: A
authors.lastname: Sharma
authors.forename: C
authors.initials: C
authors.lastname: Rogers
authors.forename: D
authors.initials: D
authors.lastname: Rimland
authors.forename: C
authors.initials: C
authors.lastname: Stafford
authors.forename: S
authors.initials: S
authors.lastname: Satola
authors.forename: E
authors.initials: E
authors.lastname: Crispell
authors.forename: R
authors.initials: R
authors.lastname: Gaynes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000382:microbiology; D010351:Patient Discharge / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000382:microbiology / Q000401:mortality*; D013997:Time Factors