Prior room occupancy increases risk of methicillin-resistant Staphylococcus aureus acquisition
Brett G. Mitchell A B F , Wilhelmine Digney C and John K. Ferguson D E
+ Author Affiliations
- Author Affiliations
A Faculty of Nursing and Health, Avondale College of Higher Education, Wahroonga, NSW 2076, Australia.
B School of Nursing, Midwifery and Paramedicine, Australian Catholic University, NSW 2602, Australia.
C Launceston General Hospital, Launceston, Tas. 7250, Australia.
D Infectious Disease and Microbiology, John Hunter Hospital, Newcastle, NSW 2310, Australia.
E School of Medicine, University of Newcastle, NSW 2308, Australia.
F Corresponding author. Email: brett.mitchell@avondale.edu.au
Healthcare Infection 19(4) 135-140 https://doi.org/10.1071/HI14023
Submitted: 21 July 2014 Accepted: 14 October 2014 Published: 10 November 2014
Journal Compilation © Australasian College for Infection Prevention and Control 2014
Abstract
Background: In Australia, little is known about the risk of acquiring methicillin-resistant Staphylococcus aureus (MRSA) from prior room occupants. The aims of the study are to understand the risk of MRSA acquisition from prior room occupants and to further extend the existing knowledge-base on the role of discharge cleaning in hospitals.
Methods: A non-concurrent cohort study was undertaken in five wards at a 250-bed general hospital in Tasmania, Australia. All admitted patients were screened for MRSA. Weekly screenings for all patients who remained in hospital were undertaken. New MRSA acquisitions were identified. The exposed group were patients whose immediate prior room occupant had MRSA, while the unexposed prior room occupant did not have MRSA.
Results: 6228 patients were at risk of acquiring MRSA, with 237 new MRSA acquisitions equating to an acquisition rate of 3.8% for each at-risk patient admission. The unadjusted odds ratio for acquiring MRSA when the prior room occupant had MRSA was 2.9 (95% CI 2.2–3.9). Using logistic regression, exposure to a prior occupant harbouring MRSA remained a significant predictor of subsequent acquisition, after controlling for variables, OR 2.7 (95% CI 2.0–3.6).
Conclusion: Admission to a room previously occupied by a person with MRSA increased the odds of acquisition for the subsequent patient, independent of other risk factors. It demonstrates the necessity of having effective discharge cleaning practices in place. We believe increased attention to discharge room cleaning in hospitals is required and the reconsideration of additional recommendations for discharge cleaning.
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