Original Contribution | Published:

Inflammatory Bowel Disease

Increased Prevalence of and Associated Mortality With Methicillin-Resistant Staphylococcus aureus Among Hospitalized IBD Patients

The American Journal of Gastroenterology volume 105, pages 371377 (2010) | Download Citation

Subjects

Abstract

OBJECTIVES:

Methicillin-resistant Staphylococcus aureus (MRSA) infection has become increasingly prevalent in US hospitals, and the impact of MRSA on hospitalized inflammatory bowel disease (IBD) patients is unknown.

METHODS:

We used the Nationwide Inpatient Sample to identify admissions for IBD (n=116,842) between 1998 and 2004. We compared prevalence and in-hospital mortality of MRSA among IBD, non-IBD gastrointestinal (GI), and general medical inpatients.

RESULTS:

MRSA prevalence increased from 4.5/10,000 to 19.0/10,000 over the 7-year period (P<0.0001). After adjustment for confounders, IBD inpatients were at increased risk of MRSA compared with the non-IBD GI (adjusted odds ratio (aOR) 1.61; 95% confidence interval (CI): 1.33–1.96) and general medical (aOR 1.36; 95% CI: 1.11–1.66) groups. Of those with MRSA, catheter-related infections were specifically more common among IBD compared with non-IBD GI and general inpatients (28.8% vs. 11.0% and 8.5%, respectively, P<0.0002). Bowel surgery, parenteral nutrition, and health insurance were predictors of MRSA infection, but the first two became insignificant after controlling for length of stay (LOS). Compared with LOS ≤ 7days, MRSA was more likely among those hospitalized 8–21 days (aOR 7.40; 95% CI: 4.68–11.7) and >21 days (aOR 58.6; 95% CI: 36.0–95.3). MRSA infection was associated with sevenfold increase in mortality (aOR 7.61; 95% CI: 3.33–17.4).

CONCLUSIONS:

Hospitalized IBD patients are at increased risk of MRSA compared with non-IBD GI and general medical inpatients. Increased mortality in the IBD population associated with MRSA reinforces the importance of measures to prevent nosocomial infection and to reduce length of hospitalization.

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Author information

Affiliations

  1. Mount Sinai Hospital IBD Centre, Department of Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada

    • Geoffrey C Nguyen
    •  & Harshna Patel
  2. Harvey M. and Lyn P. Meyerhoff IBD Center, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    • Geoffrey C Nguyen
  3. Department of Medicine, Lakeridge Health, Oshawa, Ontario, Canada

    • Rachel Y Chong

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Corresponding author

Correspondence to Geoffrey C Nguyen.

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DOI

https://doi.org/10.1038/ajg.2009.581

SUPPLEMENTARY MATERIAL is linked to the online version of the paper at http://www.nature.com/ajg

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