MedicalResearch.com Interview with:
Dr. Lauren Epstein M.D., M.S.
Division of Healthcare Quality Promotion Epidemic Intelligence Service
Centers for Disease Control and Prevention
Atlanta, GA, USA
Medical Research: What is the background for this study? What are the main findings?
Dr. Epstein: Nearly 80% of methicillin resistant Staphylococcus aureus (MRSA) infections occurs outside of the hospitals and mostly among individuals with a recent hospitalization. However, risk factors for MRSA infections among patients recently discharged from an acute care hospital have not been well explored. The goal of this study was to identify modifiable risk factors associated with MRSA infections among recently discharged patients to target future prevention efforts. We found that patients with a history of MRSA colonization, chronic wounds, invasive devices at discharge such as central lines and surgical drains, and those discharged from a hospital to a nursing home are at increased risk of invasive MRSA infections within 12 weeks after hospital discharge.
Medical Research: What should clinicians and patients take away from your report?
Dr. Epstein: MRSA infections are a significant public health concern and patients remain at risk for MRSA infections following acute care hospitalizations, especially in the 3 months following discharge from an acute care facility.
Patients with a prior history of MRSA colonization are at increased risk for MRSA infections following an acute care hospitalization. In addition, patients who have an invasive device (such as a central line or surgical drain) or a chronic wound at the time of discharge from a hospitalization are at increased risk of MRSA infection following discharge. Finally, patients who are discharged to a long term care facility, regardless of other risk factors, are at increased risk of MRSA infection.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Epstein: Future efforts to decrease invasive MRSA infections among patients following an acute care hospitalization should focus on prioritizing outpatient care and prompt removal of invasive devices, in addition to better chronic wound management. MRSA-specific intervention such as decolonization at the time of discharge from an acute care hospitalization should be evaluated for high risk patients. Finally, specific efforts to prevent MRSA infections following an acute care hospitalization should be part of a comprehensive nursing home infection control strategy that addresses all healthcare-associated infection risks to patient safety.
Lauren Epstein, Yi Mu, Ruth Belflower, Janine Scott, Susan Ray,Ghinwa Dumyati, Christina Felsen, Susan Petit, Kimberly Yousey-Hindes,Joelle Nadle, Lauren Pasutti, Ruth Lynfield, Linn Warnke, William Schaffner,Karen Leib, Alexander J. Kallen, Scott K. Fridkin, and Fernanda C. Lessa
Risk Factors for Invasive Methicillin-resistant Staphylococcus aureus Infection after Recent Discharge from an Acute Care Hospitalization, 2011-2013Clin Infect Dis. first published online September 3, 2015 doi:10.1093/cid/civ777
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Dr. Lauren Epstein M.D., M.S. (2015). Risk Factors For MRSA Infections After Discharge Identified MedicalResearch.com