title: Community-onset invasive methicillin-resistant Staphylococcus aureus infections following hospital discharge.
abstract: BACKGROUND
  The majority of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in the United States are community-onset and occur in persons with recent health care exposure.
  
  
  METHODS
  We performed a matched case-control study to identify risk factors for invasive MRSA infection among recently discharged patients. Cases had MRSA cultured from a normally sterile body site within 100 days following hospital discharge. Controls were matched on hospital, week of admission, and age.
  
  
  RESULTS
  Among 77 cases, the most common types of invasive MRSA infection were bloodstream infection and osteomyelitis. Independent risk factors were a history of a MRSA-positive clinical culture from a superficial body site in the 12 months preceding the invasive infection (matched odds ratio [mOR], 23; 95% confidence interval [CI]: 3.7-142), hemodialysis (mOR, 21; 95% CI: 1.7-257), prior hospitalization length of stay >5 days (mOR, 4.5; 95% CI: 1.6-12), and male sex (mOR, 2.9; 95% CI: 1.1-7.9).
  
  
  CONCLUSIONS
  Risk factors for postdischarge invasive MRSA infections can be identified prior to discharge and remain with the patient after the hospitalization ends. Measures to prevent community-onset invasive MRSA infections might start in the hospital but should also be evaluated in postdischarge settings.
authors: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. jduffy@cdc.gov
authors: Jonathan
authors: J
authors: Duffy
authors: Ghinwa
authors: G
authors: Dumyati
authors: Sandra
authors: S
authors: Bulens
authors: Swathi
authors: S
authors: Namburi
authors: Anita
authors: A
authors: Gellert
authors: Scott K
authors: SK
authors: Fridkin
authors: Fernanda C
authors: FC
authors: Lessa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D010351:Patient Discharge; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Bacteremia; Epidemiology; Risk factors
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