%0 Journal Article %1 harbarth_evaluating_2006 %A Harbarth, Stephan %A Sax, Hugo %A Fankhauser-Rodriguez, Carolina %A Schrenzel, Jacques %A Agostinho, Americo %A Pittet, Didier %D 2006 %J The American Journal of Medicine %K Admission, Control, Infection Prediction, Prevalence Staphylococcus aureus, {Methicillin-Resistant} %N 3 %P 275.e15--275.e23 %R 10.1016/j.amjmed.2005.04.042 %T Evaluating the Probability of Previously Unknown Carriage of MRSA at Hospital Admission %U http://www.sciencedirect.com/science/article/B6TDC-4J9MXY7-K/2/faa743536a58c440dae56058f4d143cb %V 119 %X Purpose We determined the prevalence and risk profile of patients with previously unknown carriage of methicillin-resistant Staphylococcus aureus (MRSA) at hospital admission.Subjects and methods We conducted a 7-month, prospective case-controlled study in adult inpatients admitted to a university hospital with endemic MRSA. Multivariate conditional logistic regression for data sets matched 1:4 was performed to identify the risk profile of newly identified MRSA carriers.Results Overall, 399 of 12 072 screened admissions (prevalence, 3.3\%) were found colonized (n = 368, 92\%) or infected (n = 31, 8\%) with MRSA. In 204 cases (prevalence, 1.7\%), MRSA carriage was newly identified. Without screening on admission, 49\% (196/399) of MRSA carriers would have been missed. We identified nine independent risk factors for newly identified MRSA carriage at admission (adjusted odds ratio): male sex (1.9); age greater than 75 years (2.0); receipt of fluoroquinolones (2.7), cephalosporins (2.1), and carbapenems (3.2) in the last 6 months; previous hospitalization (1.9) or intravenous therapy (1.7) during the last 12 months; urinary catheter at admission (2.0); and intrahospital transfer (2.4). A risk score (range, 0-13) was calculated by adding points assigned to these variables. On the basis of analysis of 1006 patients included in the case-controlled study, the probability of MRSA carriage was 8\% (28/342) in patients with a low score (\textless=1), 19\% (92/482) in patients with an intermediate score (2-4), and 46\% (84/182) in patients with a high score (\textgreater=5). The risk score had good discrimination (c-statistic, 0.73) and showed excellent calibration (P = .88).Conclusions On-admission prevalence of previously unknown MRSA carriers was high. Applying the risk score to newly admitted patients with an intermediate or high probability of MRSA carriage could allow a more effective MRSA control strategy.

@article{harbarth_evaluating_2006, abstract = {Purpose We determined the prevalence and risk profile of patients with previously unknown carriage of methicillin-resistant Staphylococcus aureus {(MRSA)} at hospital {admission.Subjects} and methods We conducted a 7-month, prospective case-controlled study in adult inpatients admitted to a university hospital with endemic {MRSA.} Multivariate conditional logistic regression for data sets matched 1:4 was performed to identify the risk profile of newly identified {MRSA} {carriers.Results} Overall, 399 of 12 072 screened admissions (prevalence, 3.3\%) were found colonized (n = 368, 92\%) or infected (n = 31, 8\%) with {MRSA.} In 204 cases (prevalence, 1.7\%), {MRSA} carriage was newly identified. Without screening on admission, 49\% (196/399) of {MRSA} carriers would have been missed. We identified nine independent risk factors for newly identified {MRSA} carriage at admission (adjusted odds ratio): male sex (1.9); age greater than 75 years (2.0); receipt of fluoroquinolones (2.7), cephalosporins (2.1), and carbapenems (3.2) in the last 6 months; previous hospitalization (1.9) or intravenous therapy (1.7) during the last 12 months; urinary catheter at admission (2.0); and intrahospital transfer (2.4). A risk score (range, 0-13) was calculated by adding points assigned to these variables. On the basis of analysis of 1006 patients included in the case-controlled study, the probability of {MRSA} carriage was 8\% (28/342) in patients with a low score ({\textless}=1), 19\% (92/482) in patients with an intermediate score (2-4), and 46\% (84/182) in patients with a high score ({\textgreater}=5). The risk score had good discrimination (c-statistic, 0.73) and showed excellent calibration {(P} = {.88).Conclusions} On-admission prevalence of previously unknown {MRSA} carriers was high. Applying the risk score to newly admitted patients with an intermediate or high probability of {MRSA} carriage could allow a more effective {MRSA} control strategy.}, added-at = {2011-03-11T10:05:34.000+0100}, author = {Harbarth, Stephan and Sax, Hugo and {Fankhauser-Rodriguez}, Carolina and Schrenzel, Jacques and Agostinho, Americo and Pittet, Didier}, biburl = {https://www.bibsonomy.org/bibtex/2da39ef6f4a98d8ef8b72a10a128dca29/jelias}, doi = {10.1016/j.amjmed.2005.04.042}, interhash = {92b5283655755dfc5a5bf6a70e13d925}, intrahash = {da39ef6f4a98d8ef8b72a10a128dca29}, issn = {0002-9343}, journal = {The American Journal of Medicine}, keywords = {Admission, Control, Infection Prediction, Prevalence Staphylococcus aureus, {Methicillin-Resistant}}, month = mar, number = 3, pages = {275.e15--275.e23}, timestamp = {2011-03-11T10:06:16.000+0100}, title = {Evaluating the Probability of Previously Unknown Carriage of {MRSA} at Hospital Admission}, url = {http://www.sciencedirect.com/science/article/B6TDC-4J9MXY7-K/2/faa743536a58c440dae56058f4d143cb}, volume = 119, year = 2006 }