Hospital, Health Care, and Community-Acquired MRSA
Methicillin-resistant Staphylococcus aureas (MRSA) is a bacterium that is resistant to many of the most commonly prescribed beta-lactam antibiotics, including penicillin, amoxycillin, oxacillin, and methicillin. Severe cases of MRSA may result in endocarditis, osteomyelitis, septicemia, or even death. Each year MRSA accounts for approximately 11,000 deaths in the United States.
MRSA typically is classified as hospital-acquired, health care-acquired, community-onset, or community-acquired. Hospital-acquired MRSA usually is the result of a nosocomial infection, often acquired following a surgical or invasive medical procedure during a hospital stay. Health care-acquired MRSA develops outside the hospital while the patient is in the community and has had recent contact or received treatment in a health care facility, such as an inpatient hospital, ambulatory surgical center, dialysis center, or nursing facility. Community-acquired MRSA occurs among community-dwelling individuals without recent hospitalization or encounters with the health care system.
Hospital, Health Care, and Community-Acquired MRSA: Estimates From California Hospitals, a statistical brief from the Healthcare Cost and Utilization Project, examines inpatient hospital stays with MRSA in California in 2013. Inpatient stays are categorized by clinical condition associated with MRSA—pneumonia, septicemia, cellulitis or skin ulcers, complications following surgery or medical care, and other clinical conditions. Patients with a MRSA-associated hospital admission who acquired the infection during the course of the hospitalization are then compared with those who acquired the infection following receipt of treatment or care in a health care facility in the past 90 days or who acquired the infection in the community.
- In 2013, over 1 out of 100 inpatient stays at California hospitals—a total of 37,627 stays—had a principal or secondary MRSA diagnosis.
- A total of 42 percent of MRSA-related hospitalizations included a cellulitis or skin ulcers diagnosis. About 17 percent of stays had MRSA pneumonia, and 16 percent had MRSA septicemia.
- Over 17 percent of patients with a MRSA diagnosis were hospitalized with MRSA two or more times during the year.
- Only 8 percent of patients developed MRSA during a hospital stay. About 42 percent of patients with a MRSA-related hospital stay had been hospitalized, were seen in the emergency department, or had undergone ambulatory surgery in the 90 days prior to the MRSA stay. About 50 percent of patients were hospitalized with community-acquired MRSA.
- Half of patients with community-acquired MRSA had a diagnosis of cellulitis or skin ulcers. Among patients with hospital-acquired MRSA, the largest proportion (38 percent) were diagnosed with pneumonia.