October 03, 2012
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More data needed to characterize MRSA risk at hospitalization

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Existing data are not adequate to identify the risk factors for methicillin-resistant Staphylococcus aureus colonization at hospitalization, researchers from the University of Ottawa suggest.

“Despite the increasing use of universal MRSA screening programs, published studies have yielded conflicting results,” the researchers wrote. “[Three studies] have each found that universal screening did not reduce the incidence of nosocomial MRSA infection, whereas [two studies] found that MRSA screening significantly reduced subsequent infections. Thus, the evidence supporting universal screening programs is inconclusive.”

The researchers identified studies using the MEDLINE and EMBASE databases searching for studies related to MRSA, surveillance, screening and risk factors. The evaluation included 27 studies that were published between 1994 and 2001. The studies comprised 68,877 participants and 2,928 cases of MRSA.

Thirty-six patient-level risk factors were examined: the most commonly examined risk factor was previous admission to the hospital. Other risk factors included previous antibiotic use, patient age and patient gender. More than half of the studies found an association between MRSA colonization and previous admission to the hospital and previous antibiotic use. In addition, less than one-third of the studies found an association between age or gender and MRSA colonization.

The definition of risk factors also varied among the studies. Previous admission to hospital was measured using 18 different definitions. Previous antibiotic use was measured using 16 different definitions.

“Existing literature cannot be used to identify risk factors for MRSA colonization at the time of hospitalization because of the variations in the study methods and risk factor definitions used in existing studies,” the researchers wrote. “Future studies should be aware of these differences and aim to develop standardized risk factor definitions.”

Disclosure: The researchers report no relevant financial disclosures.