179497 Epidemiology of Methicillin-Resistant Staphylococcus aureus (MRSA) infection among hospital patients

Monday, October 27, 2008: 8:53 AM

Mary Nelson Tran, PhD, MPH , Healthcare Information Division, Office of Statewide Health Planning and Development, Sacramento, CA
Michael L. Rodrian , Healthcare Information Division, Office of Statewide Health Planning and Development, Sacramento, CA
Jonathan Teague, MCRP , Healthcare Information Division, Office of Statewide Health Planning and Development, Sacramento, CA
     
Objective. The rising prevalence of methicillin resistance among Staphylococcus aureus (SA) infections in healthcare settings is of concern to healthcare providers internationally. This study presents the prevalence of MRSA among SA infections in California hospital patients.

Methods. Using California hospital patient discharge data for 1999 to 2006 we identified all cases with ICD-9 diagnosis codes indicating infections with SA (038.11, 482.41, or 041.11) and methicillin resistance (V09.0). We determined trends in MRSA prevalence and mortality by patient age and source of admission, identified the leading admission diagnoses, and compared SA and MRSA cases by type of discharge.

Results. MRSA volume increased from 13,504 in 1999 to 54,317 in 2006 and the prevalence of MRSA among SA cases rose from 31% to 66%. Leading admission diagnoses included skin infections and ulcers, surgical complications, septicemia, and pneumonia. MRSA prevalence in SA cases was highest among seniors (39% to 68%), but increased fastest among children (7% to 55%). It was highest for admissions from skilled nursing facilities (52% to 75%), but increased fastest for admissions from home (rising 24% to 65%). The percent of MRSA patients that died in-hospital declined 16% to 7%, but during this period the percent discharged to home rose sharply after increasingly short hospital stays.

Conclusions. Prevalence of MRSA among SA infections in hospital patients is increasing steeply among children and admissions from home. It appears that these patients are increasingly discharged early and to home

Learning Objectives:
. Following this session, participants will be able to: 1. Describe the prevalence and trend of MRSA infections among patients admitted to California hospitals. 2. Identify differences in risk of MRSA infection related to patient demographics, source of admission (home, skilled nursing, etc.), and type of admission diagnosis. 3. Recognize the coding, utility, and limitations of using of administrative patient data for tracking trends and distribution of MRSA infection among hospital patients.

Keywords: Epidemiology, Antibiotic Resistance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted this analysis as research scientist manager of the Administrative Data Programs in the Healthcare Outcomes Center, Healthcare Information Division of the Office of Statewide Health Planning and Development. I am trained in research and statistical methods (as a Ph.D and MPH) and am thoroughly familiar with OSHPD's hospital discharge data that is used for this analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Methicillin-Resistant Staphylococcus Aureus (MRSA) Trends, Prevention and Control
See more of: Epidemiology