TY - JOUR
T1 - Prevalence, risk factors, and molecular epidemiology of methicillin-resistant Staphylococcus aureus nasal and axillary colonization among psychiatric patients on admission to an academic medical center
AU - Farley, Jason E.
AU - Ross, Tracy
AU - Krall, Jenna
AU - Hayat, Matt
AU - Caston-Gaa, Ann
AU - Perl, Trish
AU - Carroll, Karen C.
N1 - Funding Information:
The research was approved by The Johns Hopkins Hospital Nursing Research Office and The Johns Hopkins University Institutional Review Board. A certificate of confidentiality was obtained from the National Institutes of Health to protect subjects from prosecution due to disclosure of sensitive risk factor information, such as self-reported substance abuse.
PY - 2013/3
Y1 - 2013/3
N2 - Background: Infection control data from psychiatric units and clinics are limited. Methods: This time series study was designed to determine the prevalence and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) colonization and/or infection among 500 men and women on admission to psychiatric units at The Johns Hopkins Hospital. Discharge surveillance was conducted to measure incidence. Molecular characterization was performed. Results: Five hundred subjects (52% male) were enrolled. The prevalence of MRSA colonization was 5.2% (26 of 498). Seven of 29 patients (24.1%) admitted with a skin and soft tissue infection (SSTI) was MRSA-positive; 4 of these patients had no other positive site, raising the total admission prevalence to 6.0%. A history of abscess (current or within the past 6 months) on admission (odds ratio [OR], 6.06; 95% confidence interval [CI], 2.40-15.31; P < .001), HIV infection (OR, 4.03; 95% CI, 1.52-10.71; P = .005), previous isolation (OR, 5.03; 95% CI, 1.76-14.35; P = .003), and unknown history of isolation (OR, 4.10; 95% CI, 1.41-11.98; P = .01) were associated with increased odds of MRSA colonization. Seven (2.6%) new MRSA colonizations were identified at discharge. Molecular analysis identified USA300 clonal MRSA isolates. Conclusions: The prevalence of MRSA colonization in this study population was greater than reported in the general population. Further studies are needed to identify transmission dynamics in this environment.
AB - Background: Infection control data from psychiatric units and clinics are limited. Methods: This time series study was designed to determine the prevalence and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) colonization and/or infection among 500 men and women on admission to psychiatric units at The Johns Hopkins Hospital. Discharge surveillance was conducted to measure incidence. Molecular characterization was performed. Results: Five hundred subjects (52% male) were enrolled. The prevalence of MRSA colonization was 5.2% (26 of 498). Seven of 29 patients (24.1%) admitted with a skin and soft tissue infection (SSTI) was MRSA-positive; 4 of these patients had no other positive site, raising the total admission prevalence to 6.0%. A history of abscess (current or within the past 6 months) on admission (odds ratio [OR], 6.06; 95% confidence interval [CI], 2.40-15.31; P < .001), HIV infection (OR, 4.03; 95% CI, 1.52-10.71; P = .005), previous isolation (OR, 5.03; 95% CI, 1.76-14.35; P = .003), and unknown history of isolation (OR, 4.10; 95% CI, 1.41-11.98; P = .01) were associated with increased odds of MRSA colonization. Seven (2.6%) new MRSA colonizations were identified at discharge. Molecular analysis identified USA300 clonal MRSA isolates. Conclusions: The prevalence of MRSA colonization in this study population was greater than reported in the general population. Further studies are needed to identify transmission dynamics in this environment.
KW - Colonization
KW - Infection control
KW - Mental health
KW - Methicillin resistant Staphylococcus aureas
KW - Psychiatry
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U2 - 10.1016/j.ajic.2012.03.028
DO - 10.1016/j.ajic.2012.03.028
M3 - Article
C2 - 22999771
AN - SCOPUS:84875364430
SN - 0196-6553
VL - 41
SP - 199
EP - 203
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 3
ER -