title: Outcome of Decolonization Therapy in a Hospital in Southern Puerto Rico.
abstract: OBJECTIVE
  Methicillin resistant Staphylococcus aureus (MRSA) is a resistant bacteria responsible for hard-to-treat infections. To understand the primary impact of this infection in healthcare settings, a retrospective study was performed at a hospital in southern Puerto Rico. Our objectives were to classify the types of MRSA infection, identify factors associated with the infection, and evaluate the outcome of decolonization therapy after its having been implemented at the hospital.
  
  
  METHODS
  Medical records of cases encompassing October 2009 through October 2011 were reviewed. A total of 761 MRSA-positive patients were identified and their infections classified as community-acquired MRSA (CA-MRSA), hospital-acquired MRSA (HA-MRSA), or healthcare-associated community-onset MRSA (HACO-MRSA). Basic demographics, reason for hospitalization, medical history, and culture sites, along with other information, were obtained for each case. SPSS v17 was used for statistical analysis. Fisher's exact test was used to measure the statistical significance of the crude OR, using the patients with CA-MRSA as the comparison group. HA-MRSA cases were compared before and after the intervention, using Epidat v4.0 to calculate the cumulative incidence of HA-MRSA before and after the implementation of decolonization therapy at the hospital.
  
  
  RESULTS
  In our study, 5.0% of the patients were found to be infected with HA-MRSA, 72.8%, with CA-MRSA, and 22.2%, with HACO-MRSA. After the intervention, we found a decrease of 10.35% (p = 0.704) in HA-MRSA, of 2.6% (p = 0.791) in CA-MRSA, and of 7.0% in HACO-MRSA (p = 0.650).
  
  
  CONCLUSIONS
  Our findings suggest that CA-MRSA could be responsible for the majority of the infections caused by MRSA within the hospital at which the study took place. Decolonization of MRSA is a useful tool in helping to control the spread of infection, although future studies are needed to confirm our study's findings.
authors.affiliation: Ponce Health Sciences University, Public Health Program, Ponce, PR.
authors.forename: Luisa
authors.initials: L
authors.lastname: Morales-Torres
authors.affiliation: Ponce Health Sciences University, Public Health Program, Ponce, PR.
authors.forename: Sharon
authors.initials: S
authors.lastname: Rodríguez
authors.affiliation: Internal Medicine Residency Program, Damas Hospital, Ponce, PR.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Toro
authors.affiliation: Infectious Disease Control Program, San Lucas Hospital, Ponce, PR.
authors.forename: Wanda
authors.initials: W
authors.lastname: Lledo
authors.affiliation: Ponce Health Sciences University, Ponce Research Institute, Ponce, PR.
authors.forename: Carmen
authors.initials: C
authors.lastname: Ortiz
authors.affiliation: Ponce Health Sciences University, Public Health Program, Ponce, PR.
authors.forename: Vivian
authors.initials: V
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D011647:Puerto Rico / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: CA-MRSA; HA-MRSA; HACO-MRSA; Incidence; Methicillin-resistant Staphylococcus aureus; Puerto Rico