title: Medical and household characteristics associated with methicillin resistant Staphylococcus aureus nasal carriage among patients admitted to a rural tertiary care hospital.
abstract: BACKGROUND
  Methicillin resistant Staphylococcus aureus (MRSA) poses a threat to patient safety and public health. Understanding how MRSA is acquired is important for prevention efforts. This study investigates risk factors for MRSA nasal carriage among patients at an eastern North Carolina hospital in 2011.
  
  
  METHODS
  Using a case-control design, hospitalized patients ages 18 - 65 years were enrolled between July 25, 2011 and December 15, 2011 at Vidant Medical Center, a tertiary care hospital that screens all admitted patients for nasal MRSA carriage. Cases, defined as MRSA nasal carriers, were age and gender matched to controls, non-MRSA carriers. In-hospital interviews were conducted, and medical records were reviewed to obtain information on medical and household exposures. Multivariable conditional logistic regression was used to derive odds ratio (OR) estimates of association between MRSA carriage and medical and household exposures.
  
  
  RESULTS
  In total, 117 cases and 119 controls were recruited to participate. Risk factors for MRSA carriage included having household members who took antibiotics or were hospitalized (OR: 3.27; 95% Confidence Interval (CI): 1.24-8.57) and prior hospitalization with a positive MRSA screen (OR: 3.21; 95% CI: 1.12-9.23). A lower proportion of cases than controls were previously hospitalized without a past positive MRSA screen (OR: 0.40; 95% CI: 0.19-0.87).
  
  
  CONCLUSIONS
  These findings suggest that household exposures are important determinants of MRSA nasal carriage in hospitalized patients screened at admission.
authors.affiliation: Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. schinasi@email.unc.edu
authors.forename: Leah
authors.initials: L
authors.lastname: Schinasi
authors.forename: Steve
authors.initials: S
authors.lastname: Wing
authors.forename: Pia D M
authors.initials: PD
authors.lastname: MacDonald
authors.forename: David B
authors.initials: DB
authors.lastname: Richardson
authors.forename: Jill R
authors.initials: JR
authors.lastname: Stewart
authors.forename: Kerri
authors.initials: K
authors.lastname: L Augustino
authors.forename: Delores L
authors.initials: DL
authors.lastname: Nobles
authors.forename: Keith M
authors.initials: KM
authors.lastname: Ramsey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006780:Hospitals, Rural; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D009296:Nasal Cavity / Q000382:microbiology*; D009657:North Carolina; D010343:Patient Admission; D012111:Residence Characteristics; D055815:Young Adult