Risk factors for hospital-attributable methicillin-resistant Staphylococcus aureus (HA-MRSA) bacteremia and outcomes of HA-MRSA bacteremia post-infection reviews (PIRs) in a tertiary hospital.

BACKGROUND

Methicillin-resistant Staphylocccus aureus (MRSA) bacteremia causes significant morbidity and mortality. At our center, a semiautomated algorithm is used to identify patients with hospital-attributable (HA) MRSA bacteremia. A postinfection review (PIR) is conducted to determine contributing factors for HA-MRSA bacteremia.

METHODS

Incident cases of MRSA bacteremia between April 1, 2017 and December 31, 2023 were reviewed. Demographic and clinical characteristics of patients with HA-MRSA versus non-HA-MRSA bacteremia were analyzed using univariable and multivariable logistic regression analysis.

RESULTS

Among 341 patients with MRSA bacteremia during the study period, 122 (35.8%) had HA-MRSA bacteremia requiring PIR. Factors significantly associated with HA-MRSA bacteremia included invasive image-guided procedures within the preceding 2 weeks (aOR 8.21, 95% CI: 2.63-25.61; P < .001), new MRSA acquisition (aOR 6.01, 95% CI: 2.77-13.03; P < .001), and use of intravenous cannulas (aOR 1.99, 95% CI: 1.12-3.54; P = .019). The most common issue identified in PIRs was suboptimal adherence or erroneous administration of MRSA decolonization therapy (18.9%), which was improved through staff training and patient education.

CONCLUSIONS

HA-MRSA bacteremia was associated with preceding invasive image-guided procedures, new MRSA acquisition, and the use of intravenous cannulas. PIRs complemented data analyses by identifying practices contributing to HA-MRSA bacteremia and guiding infection prevention measures.