Community Strains of Methicillin-Resistant Staphylococcus aureus as Potential Cause of Healthcare-associated Infections, Uruguay, 2002–2004
2008

Community Strains of MRSA in Uruguay

Sample size: 182 publication 10 minutes Evidence: high

Author Information

Author(s): Benoit Stephen R., Estivariz Concepción, Mogdasy Cristina, Pedreira Walter, Galiana Antonio, Galiana Alvaro, Bagnulo Homero, Gorwitz Rachel, Fosheim Gregory E., McDougal Linda K., Jernigan Daniel

Primary Institution: Centers for Disease Control and Prevention

Hypothesis

Community-associated MRSA strains have emerged in Uruguay and may be replacing healthcare-associated MRSA strains.

Conclusion

Community-associated MRSA strains have replaced healthcare-associated MRSA strains in at least one healthcare facility in Uruguay and are causing healthcare-onset infections.

Supporting Evidence

  • CA-MRSA infections increased from 4% to 23% of all S. aureus infections over two years.
  • Healthcare-associated MRSA infections decreased from 25% to 5% during the same period.
  • 21% of patients with CA-MRSA had healthcare-onset infections.

Takeaway

In Uruguay, a type of bacteria called CA-MRSA is becoming more common in hospitals and can make people sick even after they've been admitted for other reasons.

Methodology

The study reviewed S. aureus isolates from a healthcare facility and collected data from four hospitals on patients infected with CA-MRSA.

Potential Biases

Selection bias was unlikely, but the definition of CA-MRSA was based on susceptibility patterns rather than epidemiologic risk factors.

Limitations

Misclassification of healthcare-onset infections may have occurred, and electronic records were unavailable in three facilities, potentially affecting case distribution.

Participant Demographics

Of 182 patients, 59% were male, 80% were from Montevideo, and 29% had underlying chronic medical conditions.

Statistical Information

P-Value

p<0.0001

Confidence Interval

95% CI for healthcare-onset infections: 4.8 (1.2–18.7)

Statistical Significance

p<0.0001

Digital Object Identifier (DOI)

10.3201/eid1408.071183

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