Risk Factors for Recurrent Colonization With Methicillin-Resistant Staphylococcus aureus in Community-Dwelling Adults and Children. (14th April 2015)

• Record Type: Journal Article
• Authors: Cluzet, Valerie C.; Gerber, Jeffrey S.; Nachamkin, Irving; Metlay, Joshua P.; Zaoutis, Theoklis E.; Davis, Meghan F.; Julian, Kathleen G.; Linkin, Darren R.; Coffin, Susan E.; Margolis, David J.; Hollander, Judd E.; Bilker, Warren B.; Han, Xiaoyan; Mistry, Rakesh D.; Gavin, Laurence J.; Tolomeo, Pam; Wise, Jacqueleen A.; Wheeler, Mary K.; Hu, Baofeng; Fishman, Neil O.; Royer, David; Lautenbach, Ebbing
• Is Part Of: Infection control and hospital epidemiology. Volume 36:Number 7(2015)
• Page Start: 786
• Page End: 793
• Publication Date: 2015-04-14
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2015.76
• Languages: English
• ISSNs: 0899-823X

Abstract

<abstract abstract-type="normal"> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec id="abs1" sec-type="general"> <title>OBJECTIVE</title> <p>To identify risk factors for recurrent methicillin-resistant <italic>Staphylococcus aureus</italic> (MRSA) colonization.</p> </sec> <sec id="abs2" sec-type="general"> <title>DESIGN</title> <p>Prospective cohort study conducted from January 1, 2010, through December 31, 2012.</p> </sec> <sec id="abs3" sec-type="general"> <title>SETTING</title> <p>Five adult and pediatric academic medical centers.</p> </sec> <sec id="abs4" sec-type="general"> <title>PARTICIPANTS</title> <p>Subjects (ie, index cases) who presented with acute community-onset MRSA skin and soft-tissue infection.</p> </sec> <sec id="abs5" sec-type="methods"> <title>METHODS</title> <p>Index cases and all household members performed self-sampling for MRSA colonization every 2 weeks for 6 months. Clearance of colonization was defined as 2 consecutive sampling periods with negative surveillance cultures. Recurrent colonization was defined as any positive MRSA surveillance culture after clearance. Index cases with recurrent MRSA colonization were compared with those without recurrence on the basis of antibiotic exposure, household demographic characteristics, and presence of MRSA colonization in household members.</p> </sec> <sec id="abs6" sec-type="results"> <title>RESULTS</title> <p>The study cohort comprised 195 index cases; recurrent MRSA colonization occurred in 85 (43.6%). Median time to recurrence was 53 days (interquartile range, 36–84 days). Treatment with clindamycin was associated with lower risk of recurrence (odds ratio, 0.52; 95% CI, 0.29–0.93). Higher percentage of household members younger than 18 was associated with increased risk of recurrence (odds ratio, 1.01; 95% CI, 1.00–1.02). The association between MRSA colonization in household members and recurrent colonization in index cases did not reach statistical significance in primary analyses.</p> </sec> <sec id="abs7" sec-type="conclusion"> <title>CONCLUSION</title> <p>A large proportion of patients initially presenting with MRSA skin and soft-tissue infection will have recurrent colonization after clearance. The reduced rate of recurrent colonization associated with clindamycin may indicate a unique role for this antibiotic in the treatment of such infection.</p> <p> <italic>Infect. Control Hosp. Epidemiol.</italic> 2015;36(7):786–793</p> </sec> </abstract>