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This article is part of the supplement: International Conference on Prevention & Infection Control (ICPIC 2011)

Open Access Oral presentation

Risk factors for previously unknown methicillin-resistant Staphylococcus aureus (MRSA) carriage on admission to 13 surgical wards in Europe

A Pan1*, A Lee2, B Cooper3, A Chalfine4, G Daikos5, S Garilli1, S Malhotra-Kumar6, JA Martinez7, A Patroni8, S Harbarth2 and MOSAR-04 Study Team

  • * Corresponding author: A Pan

Author Affiliations

1 Istituti Ospitalieri, Cremona, Italy

2 University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland

3 Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand

4 Groupe Hospitalier Paris Saint-Joseph, Paris, France

5 Laiko General Hospital, Athens, Greece

6 Universiteit Antwerpen, Antwerp, Belgium

7 Hospital Clinic de Barcelona, Barcelona, Spain

8 Ospedale di Esine, Esine, Italy

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BMC Proceedings 2011, 5(Suppl 6):O85  doi:10.1186/1753-6561-5-S6-O85


The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1753-6561/5/S6/O85


Published:29 June 2011

© 2011 Pan et al; licensee BioMed Central Ltd.

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction / objectives

MRSA carriers admitted to surgical wards may pose both clinical and epidemiological problems. We performed a prospective, observational cohort study of patients screened for MRSA on admission to 13 surgical wards in 4 European hospitals, to identify risk factors of previously unknown MRSA carriage and to define a common predictive rule.

Methods

Multivariate logistic regression models were used to predict probabilities of MRSA colonization on admission based on patient characteristics. A scoring system was defined based on odds ratio results. The c-statistic was calculated to evaluate several models.

Results

We enrolled 2901 patients, of whom 111 (3.8%) were unknown MRSA carriers on admission. We identified 7 independent risk factors associated for newly identified MRSA carriage on admission: urinary catheter, nursing home residency, chronic skin disease, wounds, recent hospitalization, diabetes, and age ≥70 years. No risk factor was common to all 4 centres. The overall prediction rule with a lower cut-off had 87% sensitivity and 32% specificity, while values for a higher cut-off were 40% and 89%, respectively. Local predictive rules performed slightly better: 56% sensitivity and 96% specificity for Barcelona. The c-statistic for the model including all centres was 0.64, indicating limited predictive power of the common model.

Conclusion

Risk factors for unknown MRSA carriage vary substantially between surgical wards across Europe. A common predictive rule is of limited clinical value.

Disclosure of interest

None declared.