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Epidemiology of Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococcus in a Rural State

  • Philip M. Polgreen (a1), Susan E. Beekmann (a2), Yi Yi Chen (a3), Gary V. Doern (a2), Michael A. Pfaller (a2) (a4), Angela B. Brueggemann (a2) (a5), Loreen A. Herwaldt (a1) (a4) (a6) and Daniel J. Diekema (a1) (a2) (a3) (a7)...
Abstract
Background.

Most data on methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) isolates come from large tertiary care centers. Infection control personnel need to understand the epidemiology of MRSA and VRE across the continuum of care, including small rural hospitals, to develop effective control strategies.

Objective.

To describe the epidemiology of MRSA and VRE in Iowa.

Setting.

Fifteen hospitals in Iowa.

Methods.

Between July 1998 and June 2001, a total of 1,968 S. aureus isolates and 1,845 Enterococcus isolates from patients infected with these pathogens were examined. Multivariate models were developed to evaluate patient and institutional risk factors for MRSA infection and VRE infection.

Results.

The proportion of S. aureus isolates resistant to methicillin was 31%, and the proportion of Enterococcus isolates resistant to vancomycin was 6%. Independent risk factors for MRSA infection included residence in a long-term care facility, age of more than 60 years, hospitalization in a hospital with less than 200 short-term care beds, and acquiring the infection in the hospital. Independent risk factors for VRE infection included use of a central venous catheter, residence in a long-term care facility, acquisition of infection in the hospital, and hospitalization in a hospital with more than 200 short-term care beds.

Conclusions.

In Iowa, the epidemiology of MRSA differ from those of VRE. MRSA has become established in small rural hospitals. Effective MRSA control strategies may require inclusion of all hospitals in a state or region.

Copyright
Corresponding author
C 606 General Hospital, University of Iowa Hospital, 200 Hawkins Drive, Iowa City, Iowa 52246 (daniel-diekema@uiowa.edu)
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1. N Safdar , DG Maki . The commonality of risk factors for nosocomial colonization and infection with antimicrobial-resistant Staphylococcus aureus enterococcus, gram-negative bacilli, Clostridium difficile, and Candida. Ann Intern Med 2002;136:834844.

2.Centers for Disease Control and Prevention. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2003, issued August 2003. Am J Infect Control 2003;31:481498.

3. DJ Diekema , T BootsMiller , T Vaughn , et al. Antimicrobial resistance trends and outbreak frequency in United States hospitals. Clin Infect Dis 2004;38:7885.

4. MB Edmond , SE Wallace , DK McClish , MA Pfaller , RN Jones , RP Wenzel . Nosocomial bloodstream infections in US hospitals: a three-year analysis. Clin Infect Dis 1999;29:239244.

6. J Verhoef , D Beaujean , H Blok , et al. A Dutch approach to methicillin-resistant Staphylococcus aureus. Eur J Clin Microbiol Infect Dis 1999;18: 461466.

10. DJ Diekema , SA Messer , SA Coffman , et al. The epidemiology of can-didemia: three year results from the Emerging Infections and the Epidemiology of Iowa Organisms study. J Clin Microbiol 2002;40:12981302.

13. KB Stevenson , K Searle , GJ Stoddard , MH Samore . Methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci in rural communities, Western United States. Emerg Infect Dis 2005;11:895903.

17.Centers for Disease Control and Prevention. Four pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus—Minnesota and North Dakota, 1997-1999. JAMA 1999;282:11231125.

18. BC Herold , LC Immergluck , MC Maranan , et al. Community-acquired MRSA in children with no identified predisposing risk. JAMA 1998;279: 593598.

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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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