Study details

For the study, researchers analyzed more than 158 million insurance claims between 2001 and 2021 and found methicillin-resistant staph (MRSA) in 424,512 cases among 343,524 insured people.

Of those cases, the researchers found 4,724 cases of MRSA potentially being transferred to a family member from a relative who had recently been in the hospital and had a MRSA diagnosis. They also found 8,064 potential MRSA transmissions that occurred after the family member who didn't have a MRSA infection was hospitalized.

"Patients can become colonized with MRSA during their hospital stay and transmit MRSA to their household members," said Aaron Miller, lead researcher on the study and research assistant professor of internal medicine-infectious diseases at the University of Iowa. "This suggests hospitals contribute to the spread of MRSA into the community through discharged patients who are asymptomatic carriers."

The researchers found that people who had a hospitalized family member with MRSA within the last 30 days were 71 times more likely to get a MRSA infection themselves. Even after removing patients with known MRSA cases, the study found that exposure to a family member recently discharged from the hospital was associated with a 44% increased risk of MRSA infection.

That risk of infection increased the longer a family member spent in the hospital. If a patient was in the hospital one to three days in the previous month, their chance of a relative getting a MRSA infection increased by 34%, compared to people with no recent hospitalizations in the household.

In addition, if a family member was hospitalized for four to 10 days, the odds of a relative getting a MRSA infection were 49% higher. If the stay was longer than 10 days, the risk of a relative getting an infection increased by 70% to 80%.

MRSA infections are also called superbugs because they don't respond to common antibiotics, which makes them difficult to treat. Most patients with MRSA are asymptomatic, but the bacteria can cause painful swelling if it gets under the skin and can be lethal to other parts of the body, including the blood or lungs.

Discussion

According to Thomas Talbot, chief hospital epidemiologist at Vanderbilt University Medical Center and president of the Society for Healthcare Epidemiology of America (SHEA), the study "illustrates the risk of spread of resistant pathogens related to healthcare and highlights the essential importance of core infection practices."

"Hand hygiene, environmental cleaning, and standard interventions to reduce Staphylococcal colonization are crucial to preventing the spread of resistant bacteria in healthcare settings," Talbot added.

Miller noted that it's important to "not over-emphasize the hospital stay risk. While we identified a significant risk factor for transmission in the household and community, the absolute risk remains relatively low."

Miller recommends that hospitals improve infection control practices, including testing for MRSA colonization, especially at discharge, even if there aren't any signs of infection. He added that MRSA colonization and infections could be tracked among patients and their household contacts to identify and mitigate transmission more effectively. (Reed, Axios, 8/7; SHEA press release, 8/7)

Advisory Board resources on clinical quality

Advisory Board has several resources on clinical quality for your organization, including:

• C-Suite Cheat Sheet: Hospital-Acquired Condition Reduction Program
• How to tackle the 4 root causes of stagnating clinical quality
• 4 ways to 'fire-proof' your quality efforts
• Toolkit for Building Implementation-Ready Care Standards
• Reducing Unwarranted Care Variation Resource Library