Please use this identifier to cite or link to this item: https://doi.org/10.1186/1471-2334-13-491
Title: Progression from new methicillin-resistant Staphylococcus aureus colonisation to infection: An observational study in a hospital cohort
Authors: Balm, M.N.D.
Lover, A.A. 
Salmon, S.
Tambyah, P.A.
Fisher, D.A.
Keywords: Colonisation
Hospital-associated infection
MRSA
Issue Date: 22-Oct-2013
Citation: Balm, M.N.D., Lover, A.A., Salmon, S., Tambyah, P.A., Fisher, D.A. (2013-10-22). Progression from new methicillin-resistant Staphylococcus aureus colonisation to infection: An observational study in a hospital cohort. BMC Infectious Diseases 13 (1) : -. ScholarBank@NUS Repository. https://doi.org/10.1186/1471-2334-13-491
Abstract: Background: Patients newly colonised with methicillin-resistant Staphylococcus aureus (MRSA) are at higher risk of clinical MRSA infection. At present, there are limited data on the duration or magnitude of this risk in a hospital population with a known time of MRSA acquisition.Methods: A retrospective cohort study of 909 adult patients known to have newly identified MRSA colonisation during admission to National University Hospital, Singapore between 1 July 2007 and 30 June 2011 was undertaken. Patients were excluded if they had history of previous MRSA colonisation or infection, or if they had been a hospital inpatient in the preceding 12 months. Data were collected on the development of MRSA infection requiring hospitalisation up to 30 June 2012.Results: Of 840 patients newly colonised with MRSA as identified on active surveillance and not clinical specimens, 546 were men (65.0%) and the median age was 65 years (range 18-103 years). Median follow up was 24 months (range 0 -64 months, 85.1% followed >6 months). Clinical infection occurred in 121 patients (14.4%) with median time to infection of 22 days (95% CI 14-31). Overall 71.9% (87/121) of infected patients developed infection within 60 days of the date MRSA colonisation was detected. However, 17/121 patients (14.0%) developed clinical infection more than six months after documented MRSA acquisition. The most common sites of clinical infection were skin and soft tissue (49/121, 40.5%, 95% CI 31.7-49.8), respiratory tract (37/121, 30.6%, 95% CI 22.5-39.6) and bone and joint infections (14/121, 11.6%, 95% CI 6.5-18.7). Thirteen patients (13/121, 10.7%, 95% CI 5.8-17.7) had bacteraemias, of which six (5.0% 95% CI 1.8-10.5) were primary and seven (5.7%, 95% CI 2.3-11.6) were secondary to infection at other sites. Crude mortality at 30 days and six months was higher in patients with MRSA infection than colonisation alone (aOR 5.49, 95% CI 2.75-10.95, p
Source Title: BMC Infectious Diseases
URI: http://scholarbank.nus.edu.sg/handle/10635/109027
ISSN: 14712334
DOI: 10.1186/1471-2334-13-491
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