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Updated: May 20, 2026
Biosensor for Detection of Antibiotic Resistant Staphylococcus Bacteria
Published on: May 8, 2013
Increasing burden of methicillin-resistant Staphylococcus aureus hospitalizations at US academic medical centers,
Michael Z David1, Sofia Medvedev, Samuel F Hohmann
1Department of Medicine, University of Chicago, Chicago, Illinois 60637, USA. mdavid@medicine.bsd.uchicago.edu
Objective:
The incidence of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in the United States decreased during 2005-2008, but noninvasive community-associated MRSA (CA-MRSA) infections also frequently lead to hospitalization. We estimated the incidence of all MRSA infections among inpatients at US academic medical centers (AMCs) per 1,000 admissions during 2003-2008.
Design:
Retrospective cohort study.
Setting And Participants:
Hospitalized patients at 90% of nonprofit US AMCs during 2003-2008.
Methods:
Administrative data on MRSA infections from a hospital discharge database (University HealthSystem Consortium [UHC]) were adjusted for underreporting of the MRSA V09.0 International Classification of Diseases, Ninth Revision, Clinical Modification code and validated using chart reviews for patients with known MRSA infections in 2004-2005, 2006, and 2007.
Results:
The mean sensitivity of administrative data for MRSA infections at the University of Chicago Medical Center in three 12-month periods during 2004-2007 was 59.1%. On the basis of estimates of billing data sensitivity from the literature and the University of Chicago Medical Center, the number of MRSA infections per 1,000 hospital discharges at US AMCs increased from 20.9 (range, 11.1-47.7) in 2003 to 41.7 (range, 21.9-94.0) in 2008. At the University of Chicago Medical Center, among infections cultured more than 3 days prior to hospital discharge, CA-MRSA infections were more likely to be captured in the UHC billing-derived data than were healthcare-associated MRSA infections.
Conclusions:
The number of hospital admissions for any MRSA infection per 1,000 hospital admissions overall increased during 2003-2008. Use of unadjusted administrative hospital discharge data or surveillance for invasive disease far underestimates the number of MRSA infections among hospitalized patients.
Insights
The number of hospital admissions for methicillin-resistant Staphylococcus aureus (MRSA) infections increased from 2003 to 2008. Relying on administrative data or invasive disease surveillance significantly underestimates MRSA infections in hospitalized patients.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Public Health Surveillance
Background:
- Invasive methicillin-resistant Staphylococcus aureus (MRSA) infections decreased in the US from 2005-2008.
- Noninvasive community-associated MRSA (CA-MRSA) infections frequently lead to hospitalization.
- Accurate estimation of MRSA incidence is crucial for effective public health strategies.
Purpose of the Study:
- To estimate the incidence of all MRSA infections among inpatients at US academic medical centers (AMCs).
- To analyze trends in MRSA infections per 1,000 admissions from 2003-2008.
- To evaluate the accuracy of administrative data for MRSA surveillance.
Main Methods:
- Retrospective cohort study utilizing administrative data from the University HealthSystem Consortium (UHC) discharge database.
- Data from 90% of nonprofit US AMCs between 2003-2008.
- Adjustment for underreporting of MRSA codes and validation through chart reviews.
Main Results:
- The number of MRSA infections per 1,000 hospital discharges in US AMCs increased from 20.9 in 2003 to 41.7 in 2008.
- The sensitivity of administrative data for MRSA infections was 59.1% at one center.
- Community-associated MRSA (CA-MRSA) was more likely to be captured in billing data than healthcare-associated MRSA.
Conclusions:
- Overall hospital admissions for MRSA infections per 1,000 admissions increased significantly between 2003 and 2008.
- Unadjusted administrative data and surveillance for invasive disease underestimate MRSA infections in hospitalized patients.
- Improved surveillance methods are needed to accurately capture the burden of MRSA in healthcare settings.
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