title: Risk factors for methicillin-resistant Staphylococcus aureus skin and soft tissue infection in MRSA-colonized patients discharged from a Veterans Affairs hospital.
abstract: Currently, limited studies have quantified the risk of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs) for MRSA-colonized patients on discharge from hospital. Our retrospective, case-control study identified independent risk factors for the development of MRSA SSTIs among such patients detected by active MRSA nasal screening in an acute care hospital by PCR on admission, and bacteriological cultures on discharge. Cases were MRSA-colonized patients aged ⩾18 years who developed a MRSA SSTI post-discharge and controls were those who did not develop a MRSA SSTI post-discharge. Controls were matched to cases by length of follow-up (±10 days) for up to 18 months. Potential demographic and clinical risk factors for MRSA infection were identified using electronic queries and manual chart abstraction; data were compared by standard statistical tests and variables with P values ⩽0·05 in bivariable analysis were entered into a logistic regression model. Multivariable analysis demonstrated prior hospital admission within 12 months (P = 0·02), prior MRSA infection (P = 0·05), and previous myocardial infarction (P = 0·01) were independently predictive of a MRSA SSTI post-discharge. Identification of MRSA colonization upon admission and recognition of risk factors could help identify a high-risk population that could benefit from MRSA SSTI prevention strategies.
authors.affiliation: The South Texas Veterans Healthcare System,San Antonio,TX,USA.
authors.forename: J
authors.initials: J
authors.lastname: Cadena
authors.affiliation: University of Texas Health Science Center at San Antonio,San Antonio,TX,USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Richardson
authors.affiliation: The South Texas Veterans Healthcare System,San Antonio,TX,USA.
authors.forename: C R
authors.initials: CR
authors.lastname: Frei
mesh_terms: D000368:Aged; D002353:Carrier State / Q000382:microbiology*; D016022:Case-Control Studies; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D009666:Nose / Q000382:microbiology; D010343:Patient Admission; D010351:Patient Discharge; D012189:Retrospective Studies; D012307:Risk Factors; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000453:epidemiology* / Q000382:microbiology
keywords: Infection; MRSA; skin; soft tissue; surveillance