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Updated: May 29, 2026
Biosensor for Detection of Antibiotic Resistant Staphylococcus Bacteria
Published on: May 8, 2013
Methicillin-resistant Staphylococcus aureus infection and hospitalization in high-risk patients in the year following
Susan S Huang1, Virginia L Hinrichsen, Rupak Datta
1Division of Infectious Diseases and Health Policy Research Institute, School of Medicine, University of California Irvine, Irvine, California, United States of America. sshuang@uci.edu
Background:
Many studies have evaluated methicillin-resistant Staphylococcus aureus (MRSA) infections during single hospitalizations and subsequent readmissions to the same institution. None have assessed the comprehensive burden of MRSA infection in the period after hospital discharge while accounting for healthcare utilization across institutions.
Methodology/Principal Findings:
We conducted a retrospective cohort study of adult patients insured by Harvard Pilgrim Health Care who were newly-detected to harbor MRSA between January 1991 and December 2003 at a tertiary care medical center. We evaluated all MRSA-attributable infections associated with hospitalization in the year following new detection, regardless of hospital location. Data were collected on comorbidities, healthcare utilization, mortality and MRSA outcomes. Of 591 newly-detected MRSA carriers, 23% were colonized and 77% were infected upon detection. In the year following detection, 196 (33%) patients developed 317 discrete and unrelated MRSA infections. The most common infections were pneumonia (34%), soft tissue (27%), and primary bloodstream (18%) infections. Infections occurred a median of 56 days post-detection. Of all infections, 26% involved bacteremia, and 17% caused MRSA-attributable death. During the admission where MRSA was newly-detected, 14% (82/576) developed subsequent infection. Of those surviving to discharge, 24% (114/482) developed post-discharge infections in the year following detection. Half (99/185, 54%) of post-discharge infections caused readmission, and most (104/185, 55%) occurred over 90 days post-discharge.
Conclusions/Significance:
In high-risk tertiary care patients, newly-detected MRSA carriage confers large risks of infection and substantial attributable mortality in the year following acquisition. Most infections occur post-discharge, and 18% of infections associated with readmission occurred in hospitals other than the one where MRSA was newly-detected. Despite gains in reducing MRSA infections during hospitalization, the risk of MRSA infection among critically and chronically ill carriers persists after discharge and warrants targeted prevention strategies.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) carriage in high-risk patients leads to significant post-discharge infections and mortality. Targeted prevention strategies are crucial for managing persistent MRSA risks after hospital stays.
Area of Science:
- Infectious Diseases
- Healthcare Epidemiology
- Public Health
Background:
- Previous studies focused on MRSA infections within single hospitalizations.
- Limited research assessed the full MRSA burden post-discharge across healthcare settings.
- This study addresses the gap in understanding comprehensive MRSA infection risks after hospital discharge.
Purpose of the Study:
- To evaluate the burden of methicillin-resistant Staphylococcus aureus (MRSA) infections after hospital discharge.
- To assess healthcare utilization and mortality associated with MRSA in the year following detection.
- To analyze MRSA infection patterns across different healthcare institutions post-discharge.
Main Methods:
- Retrospective cohort study of adult patients with newly-detected MRSA (1991-2003).
- Inclusion of patients insured by Harvard Pilgrim Health Care.
- Analysis of MRSA infections, comorbidities, healthcare use, and mortality in the year post-detection, regardless of hospital location.
Main Results:
- Of 591 newly-detected MRSA carriers, 196 (33%) developed new MRSA infections within a year.
- Common infections included pneumonia (34%), soft tissue (27%), and bloodstream infections (18%).
- Post-discharge infections led to readmission in 54% of cases, often occurring beyond 90 days.
Conclusions:
- Newly-detected MRSA carriage poses significant risks of infection and mortality in high-risk patients.
- A substantial proportion of MRSA infections and readmissions occur after hospital discharge, across various institutions.
- Targeted post-discharge prevention strategies are essential to mitigate persistent MRSA risks.
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