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Description
MRSA continues to be an important cause of morbidity and mortality among inpatients. Blood stream infections (BSIs) are one of the most serious nosocomial complications, are relatively easy to diagnose and are a marker for the spread of other resistant organisms between hospitalized patients. In 2008, a law (SB1058) was passed that directed hospitals towards active surveillance of MRSA in an attempt to decrease rates of transmission. The law states that hospitals must screen high risk patients for MRSA colonization within 24 hours of admission. This retrospective study aims to determine whether the rate of MRSA BSIs has significantly decreased within the Scripps Health Organization in conjunction with this legislation. Positive MRSA bacteremia cultures were collected from five Scripps campuses (2007-2010, N=427) and subsequently classified as hospital- or community-associated. Student T tests and Chi-square tests were used to determine statistical differences between pre-legislation and post-legislation rates. Stepwise logistic regression was used to identify predictors for MRSA infection. Analysis revealed that while overall there was a reduction in community-associated MRSA bacteremia rates, there was not a significant reduction in hospital-associated MRSA bacteremia rates. These findings suggest that active surveillance of high risk patients has not clearly succeeded in reducing the nosocomial spread of MRSA but may help direct antibiotic choices for new hospital admissions and prevent the development of BSI in these patients. Results from this study may be useful to inform legislative action, as well as the development of more effective control interventions.
