Skip to main content
×
Home
    • Aa
    • Aa

Reduction of Methicillin-Resistant Staphylococcus aureus Infection among Veterans in Atlanta

  • Edward Stenehjem (a1) (a2), Cortney Stafford (a1) and David Rimland (a1) (a2)
Abstract
Objective.

Describe local changes in the incidence of community-onset and hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) infection and evaluate the impact of MRSA active surveillance on hospital-onset infection.

Design.

Observational study using prospectively collected data.

Setting.

Atlanta Veterans Affairs Medical Center (AVAMC).

Patients.

All patients seen at the AVAMC over an 8-year period with clinically and microbiologically proven MRSA infection.

Methods.

All clinical cultures positive for MRSA were prospectively identified, and corresponding clinical data were reviewed. MRSA infections were classified into standard clinical and epidemiologic categories. The Veterans Health Administration implemented the MRSA directive in October 2007, which required active surveillance cultures in acute care settings.

Results.

The incidence of community-onset MRSA infection peaked in 2007 at 5.45 MRSA infections per 1,000 veterans and decreased to 3.14 infections per 1,000 veterans in 2011 (P < .001 for trend). Clinical and epidemiologic categories of MRSA infections did not change throughout the study period. The prevalence of nasal MRSA colonization among veterans admitted to AVAMC decreased from 15.8% in 2007 to 11.2% in 2011 (P <.001 for trend). The rate of intensive care unit (ICU)-related hospital-onset MRSA infection decreased from October 2005 through March 2007, before the MRSA directive. Rates of ICU-related hospital-onset MRSA infection remained stable after the implementation of active surveillance cultures. No change was observed in rates of non-ICU-related hospital-onset MRSA infection.

Conclusions.

Our study of the AVAMC population over an 8-year period shows a consistent trend of reduction in the incidence of MRSA infection in both the community and healthcare settings. The etiology of this reduction is most likely multifactorial.

Copyright
Corresponding author
5121 South Cottonwood Street, Gardner Women and Newborn Center, LL2, Murray, UT 84157 (eddie.stenehjem@imail.org)
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

3. RM Klevens , JR Edwards , FC Tenover , LC McDonald , T Horan , R Gaynes . Changes in the epidemiology of methicillin-resistant Staphylococcus aureus in intensive care units in US hospitals, 1992-2003. Clin Infect Dis 2006;42(3):389391.

4. DC Burton , JR Edwards , TC Horan , JA Jernigan , SK Fridkin . Methicillin-resistant Staphylococcus aureus central line-associated bloodstream infections in US intensive care units, 1997-2007. JAMA 2009;301(7):727736.

11. DA Talan , A Krishnadasan , RJ Gorwitz , et al. Comparison of Staphylococcus aureus from skin and soft-tissue infections in US emergency department patients, 2004 and 2008. Clin Infect Dis 2011;53(2):144149.

12. LG Miller , F Perdreau-Remington , G Rieg , et al. Necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus in Los Angeles. N Engl J Med 2005;352(14): 14451453.

15. B Hota , R Lyles , J Rim , et al. Predictors of clinical virulence in community-onset methicillin-resistant Staphylococcus aureus infections: the importance of USA300 and pneumonia. Clin Infect Dis 2011;53(8):757765.

16. LA Tracy , JP Furano , AD Harris , M Singer , P Langenberg , MC Roghmann . Staphylococcus aureus infections in US veterans, Maryland, USA, 1999-2008. Emerg Infect Dis 2011;17(3): 441448.

17. TC Horan , M Andrus , MA Dudeck . CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36(5):309332.

18. RM Klevens , MA Morrison , J Nadle , et al. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA 2007;298(15):17631771.

24. EM Begier , K Frenette , NL Barrett , et al. A high-morbidity outbreak of methicillin-resistant Staphylococcus aureus among players on a college football team, facilitated by cosmetic body shaving and turf burns. Clin Infect Dis 2004;39(10): 14461453.

25. SV Kazakova , JC Hageman , M Matava , et al. A clone of methicillin-resistant Staphylococcus aureus among professional football players. N Engl J Med 2005;352(5):468475.

28. KL McGinigle , ML Gourlay , IB Buchanan . The use of active surveillance cultures in adult intensive care units to reduce methicillin-resistant Staphylococcus aureus-rehled morbidity, mortality, and costs: a systematic review. Clin Infect Dis 2008; 46(11):17171725.

31. T Gurieva , MC Bootsma , MJ Bonten . Successful Veterans Affairs initiative to prevent methicillin-resistant Staphylococcus aureus infections revisited. Clin Infect Dis 2012;54(11):16181620.

32. LO Hudson , CR Murphy , BG Spratt , et al. Differences in methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from pediatric and adult patients from hospitals in a large California county. J Clin Microbiol 2012;50(3):573579.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 7 *
Loading metrics...

Abstract views

Total abstract views: 89 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 24th May 2017. This data will be updated every 24 hours.