TY - JOUR
T1 - Burden of Invasive Methicillin-Resistant Staphylococcus aureus Infections in Nursing Home Residents
AU - Grigg, Cheri
AU - Palms, Danielle
AU - Stone, Nimalie D.
AU - Gualandi, Nicole
AU - Bamberg, Wendy
AU - Dumyati, Ghinwa
AU - Harrison, Lee H.
AU - Lynfield, Ruth
AU - Nadle, Joelle
AU - Petit, Susan
AU - Ray, Susan
AU - Schaffner, William
AU - Townes, John
AU - See, Isaac
N1 - Funding Information:
The authors would like to thank CDC staff members James Baggs and Yi Mu for analysis and database assistance; Anthony Fiore and Shelley Magill for critical feedback and discussion of results; the CDC EIP office for administrative support; and the following EIP site staff for data collection and project oversight at sites: Lauren Pasutti, Brittany Martin, Cindy Amezcua, Gretchen Rothrock, Arthur Reingold, Elizabeth Partridge, Maria Rosales (California EIP); Deborah Aragon, Claire Reisenauer, and Kenneth Gershman (Colorado EIP); Carmen Marquez, Michelle Wilson, and Heather Altier (Connecticut EIP); Randy Van Dolson, Sasha Harb, Stepy Thomas, Monica M. Farley, Wendy Baughman, Amy Tunali, Janine Ladson, Jessica Reno, Betsy Stein, and Lewis Perry (Georgia EIP); Terresa Carter, Rosemary Hollick, Kathleen Shutt, Joanne Benton, Kim Holmes, Janice Langford, and Lindsay Bonner (Maryland EIP); Kathryn Como-Sabetti, Mackenzie Koeck, and Jessica Nerby (Minnesota EIP); Anita Gellert, Christina Felsen (New York EIP); Heather Jamieson, Tasha Poissant, Mark Schmidt, and Jamie Thompson (Oregon EIP); and Gail Hughett, Terri McMinn, Brenda Barnes, Karen Leib, and Katie Dyer (Tennessee EIP). Financial Disclosure: This work was supported by a cooperative agreement through the CDC EIP (Grants U50CK000201 [California], U50CK000194 [Colorado], U50CK000195 [Connecticut], U50CK000196 [Georgia], U50CK000203 [Maryland], U50CK000204 [Minnesota], U50CK000199 [New York], U50CK000197 [Oregon], U50CK000198 [Tennessee]). The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the CDC. Conflict of Interest: No relevant conflicts of interest. Author Contributions: All authors made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data, drafting the article or revising it critically for important intellectual content, and final approval of the version to be published. Conception and drafting: Cheri Grigg, Nimalie Stone, Isaac See, Data Acquisition: Cheri Grigg, Danielle Palms, Nicole Gualandi, Wendy Bamberg, Ghinwa Dumyati, Lee H. Harrison, Ruth Lynfield, Joelle Nadle, Susan Petit, Susan Ray, William Schaffner, John Townes, Isaac See, Analysis: Cheri Grigg, Danielle Palms, Interpretation & revising: All authors. Sponsor's Role: The CDC oversaw all aspects of the study other than subject recruitment and directly determined the design, methods, analysis, and preparation.
Funding Information:
Financial Disclosure: This work was supported by a cooperative agreement through the CDC EIP (Grants U50CK000201 [California], U50CK000194 [Colorado], U50CK000195 [Connecticut], U50CK000196 [Georgia], U50CK000203 [Maryland], U50CK000204 [Minnesota], U50CK000199 [New York], U50CK000197 [Oregon], U50CK000198 [Tennessee]).
PY - 2018/8
Y1 - 2018/8
N2 - 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.
AB - 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.
KW - epidemiology
KW - invasive infections
KW - methicillin-resistant Staphylococcus aureus
KW - nursing home
UR - http://www.scopus.com/inward/record.url?scp=85053060902&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85053060902&partnerID=8YFLogxK
U2 - 10.1111/jgs.15451
DO - 10.1111/jgs.15451
M3 - Article
C2 - 30094828
AN - SCOPUS:85053060902
VL - 66
SP - 1581
EP - 1586
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
SN - 0002-8614
IS - 8
ER -