Burden of Invasive Methicillin-Resistant Staphylococcus aureus Infections in Nursing Home Residents

Cheri Grigg, Danielle Palms, Nimalie D. Stone, Nicole Gualandi, Wendy Bamberg, Ghinwa Dumyati, Lee H. Harrison, Ruth Lynfield, Joelle Nadle, Susan Petit, Susan Ray, William Schaffner, John Townes, Isaac See

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives: To describe the epidemiology and incidence of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in nursing home (NH) residents, which has previously not been well characterized. Design: Retrospective analysis of public health surveillance data. Setting: Healthcare facilities in 33 U.S. counties. Participants: Residents of the surveillance area. Measurements: Counts of NH-onset and hospital-onset (HO) invasive MRSA infections (cultured from sterile body sites) identified from the Centers for Disease Control and Prevention Emerging Infections Program (EIP) population-based surveillance from 2009 to 2013 were compared. Demographic characteristics and risk factors of NH-onset cases were analyzed. Using NH resident-day denominators from the Centers for Medicare and Medicaid Services Skilled Nursing Facility Cost Reports, incidence of NH-onset invasive MRSA infections from facilities in the EIP area was determined. Results: A total of 4,607 NH-onset and 4,344 HO invasive MRSA cases were reported. Of NH-onset cases, median age was 74, most infections were bloodstream infections, and known risk factors for infection were common: 1,455 (32%) had previous MRSA infection or colonization, 1,014 (22%) had decubitus ulcers, 1,098 (24%) had recent central venous catheters, and 1,103 (24%) were undergoing chronic dialysis; 2,499 (54%) had been discharged from a hospital in the previous 100 days. The in-hospital case-fatality rate was 19%. The 2013 pooled mean incidence of NH-onset invasive MRSA infections in the surveillance area was 2.4 per 100,000 patient-days. Conclusion: More NH-onset than HO cases occurred, primarily in individuals with known MRSA risk factors. These data reinforce the importance of infection prevention practices during wound and device care in NH residents, especially those with a history of MRSA infection or colonization.

Original languageEnglish (US)
Pages (from-to)1581-1586
Number of pages6
JournalJournal of the American Geriatrics Society
Volume66
Issue number8
DOIs
StatePublished - Aug 1 2018

Fingerprint

Methicillin-Resistant Staphylococcus aureus
Nursing Homes
Infection
Incidence
Public Health Surveillance
Population Surveillance
Skilled Nursing Facilities
Centers for Medicare and Medicaid Services (U.S.)
Central Venous Catheters
Pressure Ulcer
Centers for Disease Control and Prevention (U.S.)
Dialysis
Epidemiology
Demography
Delivery of Health Care
Costs and Cost Analysis
Equipment and Supplies

Keywords

  • epidemiology
  • invasive infections
  • methicillin-resistant Staphylococcus aureus
  • nursing home

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Grigg, C., Palms, D., Stone, N. D., Gualandi, N., Bamberg, W., Dumyati, G., ... See, I. (2018). Burden of Invasive Methicillin-Resistant Staphylococcus aureus Infections in Nursing Home Residents. Journal of the American Geriatrics Society, 66(8), 1581-1586. https://doi.org/10.1111/jgs.15451

Burden of Invasive Methicillin-Resistant Staphylococcus aureus Infections in Nursing Home Residents. / Grigg, Cheri; Palms, Danielle; Stone, Nimalie D.; Gualandi, Nicole; Bamberg, Wendy; Dumyati, Ghinwa; Harrison, Lee H.; Lynfield, Ruth; Nadle, Joelle; Petit, Susan; Ray, Susan; Schaffner, William; Townes, John; See, Isaac.

In: Journal of the American Geriatrics Society, Vol. 66, No. 8, 01.08.2018, p. 1581-1586.

Research output: Contribution to journalArticle

Grigg, C, Palms, D, Stone, ND, Gualandi, N, Bamberg, W, Dumyati, G, Harrison, LH, Lynfield, R, Nadle, J, Petit, S, Ray, S, Schaffner, W, Townes, J & See, I 2018, 'Burden of Invasive Methicillin-Resistant Staphylococcus aureus Infections in Nursing Home Residents', Journal of the American Geriatrics Society, vol. 66, no. 8, pp. 1581-1586. https://doi.org/10.1111/jgs.15451
Grigg, Cheri ; Palms, Danielle ; Stone, Nimalie D. ; Gualandi, Nicole ; Bamberg, Wendy ; Dumyati, Ghinwa ; Harrison, Lee H. ; Lynfield, Ruth ; Nadle, Joelle ; Petit, Susan ; Ray, Susan ; Schaffner, William ; Townes, John ; See, Isaac. / Burden of Invasive Methicillin-Resistant Staphylococcus aureus Infections in Nursing Home Residents. In: Journal of the American Geriatrics Society. 2018 ; Vol. 66, No. 8. pp. 1581-1586.
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abstract = "Objectives: To describe the epidemiology and incidence of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in nursing home (NH) residents, which has previously not been well characterized. Design: Retrospective analysis of public health surveillance data. Setting: Healthcare facilities in 33 U.S. counties. Participants: Residents of the surveillance area. Measurements: Counts of NH-onset and hospital-onset (HO) invasive MRSA infections (cultured from sterile body sites) identified from the Centers for Disease Control and Prevention Emerging Infections Program (EIP) population-based surveillance from 2009 to 2013 were compared. Demographic characteristics and risk factors of NH-onset cases were analyzed. Using NH resident-day denominators from the Centers for Medicare and Medicaid Services Skilled Nursing Facility Cost Reports, incidence of NH-onset invasive MRSA infections from facilities in the EIP area was determined. Results: A total of 4,607 NH-onset and 4,344 HO invasive MRSA cases were reported. Of NH-onset cases, median age was 74, most infections were bloodstream infections, and known risk factors for infection were common: 1,455 (32{\%}) had previous MRSA infection or colonization, 1,014 (22{\%}) had decubitus ulcers, 1,098 (24{\%}) had recent central venous catheters, and 1,103 (24{\%}) were undergoing chronic dialysis; 2,499 (54{\%}) had been discharged from a hospital in the previous 100 days. The in-hospital case-fatality rate was 19{\%}. The 2013 pooled mean incidence of NH-onset invasive MRSA infections in the surveillance area was 2.4 per 100,000 patient-days. Conclusion: More NH-onset than HO cases occurred, primarily in individuals with known MRSA risk factors. These data reinforce the importance of infection prevention practices during wound and device care in NH residents, especially those with a history of MRSA infection or colonization.",
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