MRSA Discussion Paper

MRSA is a common root for the healthcare-associated infections across the world, and many hospitals screen for MRSA colonization on admission as a key infection prevention strategy (McKinnell, Miller, Eells, Cui, & Huang, 2013, p. 1077). Universal screening of all admitted patients for MRSA has been suggested as a means to prevent MRSA transmission by identifying and isolating MRSA carriers, but it is very resource intense and faces many practical challenges (McKinnell et al., 2014, p. 1077). The alternate to universal screening, is the target screening of patients considered as high-risk for colonization. MRSA screening for among the high-risk patients is a legislative mandate in nine US states and has been adopted by many hospitals, but the definitions of high risk differ among hospitals and state laws, as well as a systematic evaluation of factors associated with colonization is lacking, hence this study was performed as a systematic review of the literature to assess factors …show more content…
MRSA colonization at hospital admission was associated with recent prior hospitalization (odds ratio [OR], 2.4 [95% confidence interval (CI), 1.3–4.7]; P < .01), nursing home exposure (OR, 3.8 [95% CI, 2.3–6.3]; P < .01), and history of exposure to healthcare-associated pathogens (MRSA carriage: OR, 8.0 [95%CI, 4.2–15.1]; Clostridium difficile infection: OR, 3.4 [95% CI, 2.2–5.3]; vancomycin-resistant Enterococci carriage: OR, 3.1 [95% CI, 2.5–4.0]; P < .01 for all) (McKinnell et al., 2014, p. 1077). Select comorbidities were associated with MRSA colonization (congestive heart failure, diabetes, pulmonary disease, immunosuppression, and renal failure; P < .01 for all), while others were not (human immunodeficiency virus, cirrhosis, and malignancy). ICU admission was not associated with an increased risk of MRSA colonization (OR, 1.1 [95% CI, 0.6–1.8]; P = .87) (McKinnell et al., 2014, p.