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Survival Time of Methicillin-Resistant Staphylococcus aureus–Free Status after Institutional Clearance

Part of: BARRY FARR AWARD RECIPIENTS

Published online by Cambridge University Press:  10 May 2016

Paula A. Valencia-Rey ,
Judith Strymish ,
Ernest Robillard ,
Martin Evans ,
Janice Weinberg  and
Kalpana Gupta
Paula A. Valencia-Rey
Affiliation:
Department of Medicine, Veterans Affairs Boston Healthcare System, West Roxbury, Massachusetts Department of Medicine, Boston University School of Medicine, Boston, Massachusetts Both authors contributed equally to this article
Judith Strymish
Affiliation:
Department of Medicine, Veterans Affairs Boston Healthcare System, West Roxbury, Massachusetts Harvard Medical School, Boston, Massachusetts Both authors contributed equally to this article
Ernest Robillard
Affiliation:
Department of Medicine, Veterans Affairs Boston Healthcare System, West Roxbury, Massachusetts
Martin Evans
Affiliation:
Veterans Health Administration Methicillin-Resistant Staphylococcus aureus/Multidrug-Resistant Organism Program Office, National Infectious Diseases Service, Veterans Affairs Central Office and Lexington Veterans Affairs Medical Center, Lexington, Kentucky; and Department of Internal Medicine, University of Kentucky School of Medicine, Lexington, Kentucky
Janice Weinberg
Affiliation:
Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
Kalpana Gupta*
Affiliation:
Department of Medicine, Veterans Affairs Boston Healthcare System, West Roxbury, Massachusetts Department of Medicine, Boston University School of Medicine, Boston, Massachusetts National Center for Occupational Health and Infection Control, Office of Public Health, Department of Veterans Affairs, Gainesville, Florida
*
MPH, 1400 VFW Parkway, Med 111, West Roxbury, MA 02132 (kalpana.gupta@va.gov).
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Abstract

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Objective.

To determine the durability of methicillin-resistant Staphylococcus aureus (MRSA)–free status after patients are removed from contact precautions and the association of specific clearance policy variables with survival

Design.

Retrospective cohort study from October 2007 to April 2013.

Setting.

Veteran Affairs Boston Healthcare System.

Participants.

Patients with a prior history of MRSA who were removed from contact precautions after deemed cleared of their MRSA status by infection prevention.

Methods.

Active nasal screening results and clinical data from acute, long-term, and outpatient care facilities were evaluated to determine survival of MRSA-free status in a time-to-event analysis.

Results.

A total of 351 unique patients were followed for 107,112 patient-days. The median age was 68 years. Overall, 249 (71%) of patients remained MRSA-free, and 102 (29%) reverted to MRSA positive. The median MRSA-free survival was 880 days. Comorbidities, presence of indwelling devices, and the use of systemic antibiotics at the time of clearance screening were not associated with MRSA-free survival. More than 21,000 days of inpatient isolation days were avoided during the study period.

Conclusions.

The majority of patients removed from contact precautions remained MRSA-free for more than 2 years. Antibiotic use at the time of clearance was not associated with reductions in MRSA-free survival. These findings can be used to simplify clearance criteria, promote clearance policies, and reduce patient isolation days.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 35 , Issue 10 , October 2014 , pp. 1271 - 1276
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved.

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