ID high-risk patients to reduce MRSA deaths

Although inpatient infection rates are down, providers still are looking for ways to eliminate serious infections and related health problems. One way is to identify risk factors for fatal methicillin-resistant Staphylococcus aureus (MRSA), according to research to be published in the July Emerging Infectious Diseases.

Researchers found that the risk of death from MRSA increased significantly with age, nursing home residence, organ impairment and severe bacteremia. According to most studies, severe bacteremia carries a high mortality of 30 percent to 35 percent, MedPage Today reported.

The researchers analyzed nearly 700 episodes of MRSA infections in adults at New York City's Mount Sinai Medical Center. They found that about 40 percent of the cases were healthcare-associated, and almost all the rest were hospital-associated infections.

By determining the risk that a patient with MRSA will die, providers can target appropriate interventions toward patients with the highest mortality risk, the researchers noted. With a targeted approach, hospitals could see significant reductions in infections or death.

The researchers also found that consultation with an infectious disease specialist was associated with the largest drop in mortality risk (11 percent).

"For example, an elderly patient with liver cirrhosis and MRSA bacteremia who lived in a nursing home before hospital admission would have an extremely poor prognosis," the authors wrote. "Conversely, an otherwise healthy patient with diabetes mellitus might have a better prognosis that could be improved even more by consultation with an infectious disease specialist."

The findings echo a study published in the March American Journal of Infection Control, which found that hospitals with board-certified infection prevention professionals have significantly lower rates of MRSA bloodstream infections than those that don't.

Reinforcing the call for targeted interventions, pre-screening high-risk hospital admissions for MRSA also reduces in-hospital MRSA transmissions, saving lives and money. Memorial Hermann-Texas Medical Center in Houston saved more than $100,000 annually and avoided 69 infections over four years by screening for MRSA upon patient admission and taking additional precautions when needed, according to a study published in the New England Journal of Medicine.

To learn more:
- here's the research
- read the MedPage article

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