Readmission of known MRSA carriers and MRSA colonization pressure in hospital

Area of Science:

• Infectious Diseases
• Hospital Epidemiology
• Public Health

Background:

• Asymptomatic carriers of methicillin-resistant Staphylococcus aureus (MRSA) can contribute to the hospital reservoir.
• Understanding the impact of patient readmissions on MRSA colonization pressure is crucial for infection control.

Purpose of the Study:

• To assess the impact of readmitted asymptomatic MRSA carriers on MRSA colonization pressure within a hospital setting.
• To evaluate the effectiveness of an electronic alert system in managing MRSA carriers.

Main Methods:

• Utilized an electronic alert system to track 1060 inpatients generating 2058 alerts between 2004 and 2010.
• Analyzed readmission rates, focusing on those within three months of discharge.
• Quantified MRSA patient-days and correlated new MRSA cases with hospitalized MRSA patients.

Main Results:

• 46% of patients were readmitted, with 64.4% readmitted within three months.
• Readmissions of known MRSA carriers accounted for 51.3% of total MRSA patient-days.
• A mean of 20 MRSA patients were present daily, decreasing from 40 to eight during the study period.
• New MRSA cases showed a partial correlation with the number of hospitalized MRSA patients (R² = 0.49).

Conclusions:

• Readmission of asymptomatic MRSA carriers significantly contributes to the hospital's MRSA burden.
• Rapid electronic identification and management of MRSA carriers are essential for reducing overall MRSA prevalence in hospitals.