Issue: July 2021
Disclosures: The authors report no relevant financial disclosures.
June 04, 2021
1 min read

Community-associated MRSA colonization linked to significantly increased mortality risk

Issue: July 2021
Disclosures: The authors report no relevant financial disclosures.
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Community-associated MRSA colonization was linked to a significantly increased mortality risk in middle-aged and older adults, survey data show.

Antibiotic-resistant infections such as MRSA claim 35,000 American lives each year, Arch G. Mainous III, PhD, a professor of health services administration at the University of Florida College of Medicine, told Healio Primary Care. Most often this occurs from skin-to-skin contact with a person who has MRSA colonization or infection, or by sharing items such as towels. People who inject drugs are also at high risk for MRSA infection.

11-year mortality rate among middle-aged and older adults was 35.9% among those colonized with MRSA and 17.8% among those not colonized with MRSA
Reference: Mainous AG, et al. J Am Board Fam Med. 2021;doi:10.3122/jabfm.2021.02.200394.

“Millions of people are colonized with MRSA and don’t know it,” he said. “It has been unclear what sort of downstream health risk is associated with carriage of this antibiotic-resistant bacteria.”

MRSA infections have been associated with significant morbidity and mortality, according to the researchers, but previous studies that looked for an increased risk for death associated with MRSA colonization have shown mixed results.

Arch G. Mainous III

Mainous and colleagues analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2004, which was linked to the National Death Index through December 31, 2015. The study included 118,718,486 adults aged 40 to 85 years, most of whom were white. The adults were followed for up to 11 years.

The researchers reported that 1.5% (95% CI, 1.1%-2%) of the population was colonized by MRSA. The 11-year mortality rate was 35.9% (95% CI, 25.4%-46.4%) for those with MRSA colonization and 17.8% (95% CI, 16.4%-19.2%) for noncolonized adults. The adjusted HR for mortality among MRSA-colonized adults was 1.75 (95% CI, 1.12-2.73).

However, colonization with Staphylococcus aureus in general was not associated with increased mortality, consistent with previous findings, the researchers wrote.

Mainous said that in the hospital setting, decolonization and putting patients on contact precautions have helped to successfully control MRSA, but those in the community “who don’t know that they are colonized is troubling because if the risk is undetected, then there is little that we can do for prevention.”

“Investigating the benefits of decolonization in the community would be a logical next step in our understanding of prevention,” he added.