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The incidence of MRSA infections in the United States: is a more comprehensive tracking system needed?

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ABSTRACT

A review of epidemiological studies on the incidence of MRSA infections overtime was performed along with an analysis of data available for download from Hospital Compare (https://data.medicare.gov/data/hospital-compare). We found the estimations of the incidence of MRSA infections varied widely depending upon the type of population studied, the types of infections captured and in the definitions and terminology used to describe the results. We could not find definitive evidence that the incidence of MRSA infections in U.S. community or facilities is decreasing significantly. Of concern are recent data reported to the National Healthcare Safety Network (NHSN) on MRSA bloodstream infections which indicate that by the end of 2015 there had been little change in the average facility Standardized Infection Ratio (0.988), compared to a 2010–2011 baseline and is significantly increased compared to the previous year. This is in contradistinction to the recent Veterans Administration study which reported over an 80% reduction in MRSA infections. However, this discrepancy may be due to the inability to reconcile the baselines of the two data sets; and the observed increase may be artifactual due to aberrations in the NHSN tracking system. Our review supports the need for implementation of a comprehensive tracking and monitoring system involving all types of healthcare facilities for multi-drug resistant organisms, along with concomitant funding for both staff and infrastructure. Without such a system, determining the effectiveness of interventions such as antibiotic stewardship and chlorhexidine bathing will be hindered.

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Graph of National (Patient Level) Standardized Infection Ratio (SIR) for MRSA Bloodstream Infections in relationship to MRSA goals and to the performance of VA hospitals in reducing total non-ICU MRSA infections. Data was used only from hospitals that also had a calculable SIR. The data acquisition periods for the SIR are shown in Table 1. Only the baseline and final data points for the VA MRSA Infections are shown
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Fig2: Graph of National (Patient Level) Standardized Infection Ratio (SIR) for MRSA Bloodstream Infections in relationship to MRSA goals and to the performance of VA hospitals in reducing total non-ICU MRSA infections. Data was used only from hospitals that also had a calculable SIR. The data acquisition periods for the SIR are shown in Table 1. Only the baseline and final data points for the VA MRSA Infections are shown

Mentions: As shown in Fig. 2, there has been little or no change in infection rates compared to the 2010 to 2011 baseline [9]. Initially, there appeared to be a slight decrease, but the rates have trended upward and returned to the baseline. It should be noted that the baseline data was collected under voluntary reporting, as the subsequent data shown in Table 1 was collected with mandatory reporting. Thus, one could argue that the baseline data was from higher performing facilities. In addition, the increase observed in 2015 may have been caused by methodological changes in how community MRSA environmental pressure is calculated. However, the data indicates that there has been little change in hospital-onset MRSA bloodstream infection rates between the initial and final mandatory reporting periods as shown in Fig. 2 and Table 1, and that as of 2015 the United States did not achieve the MRSA bloodstream infection reduction goal of 25% [10].Fig. 2


The incidence of MRSA infections in the United States: is a more comprehensive tracking system needed?
Graph of National (Patient Level) Standardized Infection Ratio (SIR) for MRSA Bloodstream Infections in relationship to MRSA goals and to the performance of VA hospitals in reducing total non-ICU MRSA infections. Data was used only from hospitals that also had a calculable SIR. The data acquisition periods for the SIR are shown in Table 1. Only the baseline and final data points for the VA MRSA Infections are shown
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5383958&req=5

Fig2: Graph of National (Patient Level) Standardized Infection Ratio (SIR) for MRSA Bloodstream Infections in relationship to MRSA goals and to the performance of VA hospitals in reducing total non-ICU MRSA infections. Data was used only from hospitals that also had a calculable SIR. The data acquisition periods for the SIR are shown in Table 1. Only the baseline and final data points for the VA MRSA Infections are shown
Mentions: As shown in Fig. 2, there has been little or no change in infection rates compared to the 2010 to 2011 baseline [9]. Initially, there appeared to be a slight decrease, but the rates have trended upward and returned to the baseline. It should be noted that the baseline data was collected under voluntary reporting, as the subsequent data shown in Table 1 was collected with mandatory reporting. Thus, one could argue that the baseline data was from higher performing facilities. In addition, the increase observed in 2015 may have been caused by methodological changes in how community MRSA environmental pressure is calculated. However, the data indicates that there has been little change in hospital-onset MRSA bloodstream infection rates between the initial and final mandatory reporting periods as shown in Fig. 2 and Table 1, and that as of 2015 the United States did not achieve the MRSA bloodstream infection reduction goal of 25% [10].Fig. 2

View Article: PubMed Central - PubMed

ABSTRACT

A review of epidemiological studies on the incidence of MRSA infections overtime was performed along with an analysis of data available for download from Hospital Compare (https://data.medicare.gov/data/hospital-compare). We found the estimations of the incidence of MRSA infections varied widely depending upon the type of population studied, the types of infections captured and in the definitions and terminology used to describe the results. We could not find definitive evidence that the incidence of MRSA infections in U.S. community or facilities is decreasing significantly. Of concern are recent data reported to the National Healthcare Safety Network (NHSN) on MRSA bloodstream infections which indicate that by the end of 2015 there had been little change in the average facility Standardized Infection Ratio (0.988), compared to a 2010–2011 baseline and is significantly increased compared to the previous year. This is in contradistinction to the recent Veterans Administration study which reported over an 80% reduction in MRSA infections. However, this discrepancy may be due to the inability to reconcile the baselines of the two data sets; and the observed increase may be artifactual due to aberrations in the NHSN tracking system. Our review supports the need for implementation of a comprehensive tracking and monitoring system involving all types of healthcare facilities for multi-drug resistant organisms, along with concomitant funding for both staff and infrastructure. Without such a system, determining the effectiveness of interventions such as antibiotic stewardship and chlorhexidine bathing will be hindered.

No MeSH data available.


Related in: MedlinePlus