title: Predischarge postpartum methicillin resistant Staphylococcus aureus infection and group B streptococcus carriage at the individual and hospital levels.
abstract: BACKGROUND
  We sought to characterize the relationship between individual group B streptococcus (GBS) colonization and pre-discharge postpartum methicillin resistant Staphylococcus aureus (MRSA) infection in United States women delivering at term. We also sought to examine the association between hospital GBS colonization prevalence and MRSA infection.
  
  
  METHODS
  Data was from the Nationwide Inpatient Sample, a representative sample of United States community hospitals. Hierarchical regression models were used to estimate odds ratios adjusted for patient age, race, expected payer, and prepregnancy diabetes and hospital teaching status, urbanicity, ownership, size, and geographic region. We used multiple imputation for missing covariate data.
  
  
  RESULTS
  There were 3,136,595 deliveries and 462 cases of MRSA infection included in this study. The odds ratio for individual GBS colonization was 1.2 (95% confidence interval: 0.9 to 1.5). For a five-percent increase in the hospital prevalence of GBS colonization, the odds ratio was 0.9 (95% CI: 0.1 to 5.6).
  
  
  CONCLUSIONS
  The odds ratio estimate for the association of hospital GBS prevalence with MRSA infection is too imprecise to make conclusions about its magnitude and direction. Barring major bias in our estimates, individual GBS carriage does not appear to be strongly associated with predischarge postpartum MRSA infection.
authors.affiliation: Department of Health Policy and Management, UCLA Fielding School of Public Health, 650 Charles E. Young Drive S., 31-269 CHS, Los Angeles, CA 90095, USA.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Parriott
authors.affiliation: Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive S., 71-236 CHS, Los Angeles, CA 90095, USA ; Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, 50 Beale Street, San Francisco, CA 94105, USA.
authors.forename: Joelle M
authors.initials: JM
authors.lastname: Brown
authors.affiliation: Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive S., 71-236 CHS, Los Angeles, CA 90095, USA ; UCLA Center for Health Policy Research, 10960 Wilshire Boulevard No. 1550, Los Angeles, CA 90024, USA ; Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1100 DE Amsterdam, The Netherlands.
authors.forename: Onyebuchi A
authors.initials: OA
authors.lastname: Arah
mesh_terms: D000328:Adult; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D049590:Postpartum Period; D011247:Pregnancy; D015995:Prevalence; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013290:Streptococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013292:Streptococcus agalactiae / Q000302:isolation & purification*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
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