Grigg C, et al. - In nursing home (NH) residents, researchers analyzed the epidemiology and incidence of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections, which has previously not been well characterized. They found that, mainly in individuals with known MRSA risk factors, the occurrence of NH-onset cases was more than hospital-onset (HO) cases. These data strengthened the importance of infection prevention practices during wound and device care in NH residents, particularly those with a history of MRSA infection or colonization.

Methods

• Researchers performed retrospective analysis of public health surveillance data from healthcare facilities in 33 U.S. counties.
• Participants were residents of the surveillance area.
• They compared 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.
• They also analyzed demographic characteristics and risk factors of NH-onset cases.
• They determined incidence of NH-onset invasive MRSA infections from facilities in the EIP area by using NH resident-day denominators from the Centers for Medicare and Medicaid Services Skilled Nursing Facility Cost Reports.

Results

• They reported 4,607 NH-onset and 4,344 HO invasive MRSA cases.
• They noted that NH-onset cases had median age 74, and these cases mostly had bloodstream infections, and commonly had known risk factors for infection: 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.
• According to findings, 19% was reported to be in-hospital case-fatality rate.
• Data showed that the 2013 pooled mean incidence of NH-onset invasive MRSA infections in the surveillance area was 2.4 per 100,000 patient-days.