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What Is Nosocomial? Large Variation in Hospital Choice of Numerators and Denominators Affects Rates of Hospital-Onset Methicillin-Resistant Staphylococcus aureus

Published online by Cambridge University Press:  02 January 2015

Rupak Datta ,
Melissa Kuo King ,
Diane Kim ,
Christopher Nguyen ,
Kristen Elkins ,
Adrijana Gombosev ,
Taliser R. Avery ,
Hildy Meyers ,
Michele Cheung  and
Susan S. Huang
Rupak Datta*
Affiliation:
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California
Melissa Kuo King
Affiliation:
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California
Diane Kim
Affiliation:
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California
Christopher Nguyen
Affiliation:
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California
Kristen Elkins
Affiliation:
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California
Adrijana Gombosev
Affiliation:
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California
Taliser R. Avery
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts
Hildy Meyers
Affiliation:
Epidemiology and Assessment, Orange County Health Care Agency, Santa Ana, California
Michele Cheung
Affiliation:
Epidemiology and Assessment, Orange County Health Care Agency, Santa Ana, California
Susan S. Huang
Affiliation:
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, California Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
*
University of California Irvine School of Medicine, Health Policy Research Institute, 100 Theory, Suite 110, Irvine, CA 92697 ([email protected])
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Abstract

We calculated hospital-onset methicillin-resistant Staphylococcus aureus (HO-MRSA) rates for Orange County, California, hospitals using survey and state data. Numerators were variably defined as HO-MRSA occurring more than 48 hours (37%), more than 2 days (30%), and more than 3 days (33%) postadmission. Survey-reported denominators differed from state-reported patient-days. Numerator and denominator choices substantially impacted HO-MRSA rates.

Type
Concise Communication
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 11 , November 2012 , pp. 1166 - 1169
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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References

1.MRSA laws. http://utility.apic.org/downloads/legislation/MRSA_map.gif. Accessed March 20, 2012.Google Scholar
2.Weber, SG, Huang, SS, Oriola, S, et al.Legislative mandates for active surveillance cultures for MRSA and VRE: position statement from the joint SHEA and APIC task force. Infect Control Hosp Epidemiol 2007;28(3):249–260. (Jointly published in Am J Infect Control 2007;35(2):73–85.)CrossRefGoogle ScholarPubMed
3.Horan, TC, Andrus, M, Dudeck, MA. CDC/NHSN surveillance definition of healthcare-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36:309–332.Google Scholar
4.Cohen, AL, Calfee, D, Fridkin, SK, et al.Recommendations for metrics for multidrug-resistant organisms in healthcare settings: SHEA/HICPAC position paper. Infect Control Hosp Epidemiol 2008;29:901–913.Google Scholar
5.Centers for Disease Control and Prevention National Healthcare Safety Network. Multidrug-resistant organism infection surveillance training. http://www.cdc.gov/nhsn/wc_MDRO_CDAD.html. Accessed March 20, 2012.Google Scholar
6.Furuya, EY, Larson, E, Landers, T, Jia, H, Ross, B, Behta, M. Challenges of applying the SHEA/HICPAC metrics for multidrug-resistant organisms to a real-world setting. Infect Control Hosp Epidemiol 2011;32:323–332.Google Scholar
7.Huang, SS, Rifas-Shiman, SL, Warren, DK, et al, and the Centers for Disease Control and Prevention Epicenters Program. Improving methicillin-resistant Staphylococcus aureus surveillance and reporting in intensive care units. J Infect Dis 2007;195(3):330–338. Electronically published December 27, 2006.Google Scholar
8.California Office of Statewide Health Planning and Development. http://www.oshpd.ca.gov. Accessed March 20, 2012.Google Scholar
9.Fridkin, SK. HICPAC Surveillance Work Group: update on NHSN CLABSI definition and progress. Centers for Disease Control and Prevention. Healthcare Infection Control Practices Advisory Committee meeting, November 3–4, 2011. Washington, DC.Google Scholar
10.DeFrances, CJ, Lucas, CA, Buie, VC, Golosinskiy, A. 2006 national hospital discharge survey. National Health Statistics Report, no. 5. Centers for Disease Control and Prevention. http://www xdc.gov/nchs/data/nhsr/nhsr005.pdf. Published July 30, 2008. Accessed March 20, 2012.Google Scholar