title: Hospital and provider patient volumes, cesarean section rates, and early postpartum invasive methicillin-resistant Staphylococcus aureus infection.
abstract: OBJECTIVE
  We sought to examine whether hospital and provider volumes and cesarean section rates influenced early postpartum invasive methicillin-resistant Staphylococcus aureus (MRSA) infection.
  
  
  METHODS
  We used data from the Nationwide Inpatient Sample, a representative sample of US community hospitals. Multivariate hierarchical regression models were used to estimate odds ratios adjusted for hospital total discharges, nurse:patient ratio, urbanicity, teaching status, bed size, ownership, and geographic region and patient age, race, expected payer, and comorbidities.
  
  
  RESULTS
  The total sample size for the hospital analysis was 3,487,350 deliveries, which included 555 cases of MRSA infection. The total sample size for the provider analysis was 1,186,703 deliveries, with 221 cases of MRSA infection. Hospital and provider patient (deliveries) volumes and cesarean section rates were not associated with early postpartum invasive MRSA infection.
  
  
  CONCLUSIONS
  Barring major bias in our estimates, our results suggest that transmission from providers may not be a predominant route of postpartum MRSA infection in US hospitals.
authors.affiliation: Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA. Electronic address: aparriott@ucla.edu.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Parriott
authors.affiliation: Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA.
authors.forename: Joelle M
authors.initials: JM
authors.lastname: Brown
authors.affiliation: Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA.
authors.forename: Onyebuchi A
authors.initials: OA
authors.lastname: Arah
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006764:Hospitals, Community; D061847:Hospitals, High-Volume; D061846:Hospitals, Low-Volume; D006801:Humans; D007231:Infant, Newborn; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D049590:Postpartum Period; D011247:Pregnancy; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus; D014481:United States / Q000453:epidemiology
keywords: Drug resistance; Hospital statistics; Numerical data; Obstetrics; Puerperal infection; Staphylococcal infections