Ward-level factors associated with methicillin-resistant Staphylococcus aureus acquisition-an electronic medical records study in Singapore.

<h4>Background</h4>Methicillin-Resistant Staphylococcus aureus (MRSA) is endemic in hospitals worldwide. Intrahospital transfers may impact MRSA acquisition risk experienced by patients. In this study, we investigated ward characteristics and connectivity that are associated with MRSA ac...

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Autores principales:	Zaw Myo Tun, Dale A Fisher, Sharon Salmon, Clarence C Tam
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/81be815bc462400bb6773463c9e42e47
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spelling	oai:doaj.org-article:81be815bc462400bb6773463c9e42e472021-12-02T20:06:36ZWard-level factors associated with methicillin-resistant Staphylococcus aureus acquisition-an electronic medical records study in Singapore.1932-620310.1371/journal.pone.0254852https://doaj.org/article/81be815bc462400bb6773463c9e42e472021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254852https://doaj.org/toc/1932-6203<h4>Background</h4>Methicillin-Resistant Staphylococcus aureus (MRSA) is endemic in hospitals worldwide. Intrahospital transfers may impact MRSA acquisition risk experienced by patients. In this study, we investigated ward characteristics and connectivity that are associated with MRSA acquisition.<h4>Methods</h4>We analysed electronic medical records on patient transfers and MRSA screening of in-patients at an acute-care tertiary hospital in Singapore to investigate whether ward characteristics and connectivity within a network of in-patient wards were associated with MRSA acquisition rates over a period of four years.<h4>Results</h4>Most patient transfers concentrated in a stable core network of wards. Factors associated with increased rate of MRSA acquisition were MRSA prevalence among patients transferred from other wards (rate ratio (RR): 7.74 [95% confidence interval (CI): 3.88, 15.44], additional 5 percentage point), critical care ward (RR: 1.72 [95% CI: 1.09, 2.70]) and presence of MRSA cohorting beds (RR: 1.39 [95% CI: 1.03, 1.90]. Oncology ward (RR: 0.66 [95% CI: 0.46, 0.94]) (compared to medical ward), and median length of stay (RR: 0.70 [95% CI: 0.55, 0.90], additional 1.5 days) were associated with lower acquisition rates. In addition, we found evidence of interaction between MRSA prevalence among patients transferred from other wards and weighted in-degree although the latter was not associated with MRSA acquisition after controlling for confounders.<h4>Conclusion</h4>Wards with higher MRSA prevalence among patients transferred from other wards were more likely to have higher MRSA acquisition rate. Its effect further increased in wards receiving greater number of patients. In addition, critical care ward, presence of MRSA cohorting beds, ward specialty, and median length of stay were associated with MRSA acquisition.Zaw Myo TunDale A FisherSharon SalmonClarence C TamPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254852 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Zaw Myo Tun Dale A Fisher Sharon Salmon Clarence C Tam Ward-level factors associated with methicillin-resistant Staphylococcus aureus acquisition-an electronic medical records study in Singapore.
description	<h4>Background</h4>Methicillin-Resistant Staphylococcus aureus (MRSA) is endemic in hospitals worldwide. Intrahospital transfers may impact MRSA acquisition risk experienced by patients. In this study, we investigated ward characteristics and connectivity that are associated with MRSA acquisition.<h4>Methods</h4>We analysed electronic medical records on patient transfers and MRSA screening of in-patients at an acute-care tertiary hospital in Singapore to investigate whether ward characteristics and connectivity within a network of in-patient wards were associated with MRSA acquisition rates over a period of four years.<h4>Results</h4>Most patient transfers concentrated in a stable core network of wards. Factors associated with increased rate of MRSA acquisition were MRSA prevalence among patients transferred from other wards (rate ratio (RR): 7.74 [95% confidence interval (CI): 3.88, 15.44], additional 5 percentage point), critical care ward (RR: 1.72 [95% CI: 1.09, 2.70]) and presence of MRSA cohorting beds (RR: 1.39 [95% CI: 1.03, 1.90]. Oncology ward (RR: 0.66 [95% CI: 0.46, 0.94]) (compared to medical ward), and median length of stay (RR: 0.70 [95% CI: 0.55, 0.90], additional 1.5 days) were associated with lower acquisition rates. In addition, we found evidence of interaction between MRSA prevalence among patients transferred from other wards and weighted in-degree although the latter was not associated with MRSA acquisition after controlling for confounders.<h4>Conclusion</h4>Wards with higher MRSA prevalence among patients transferred from other wards were more likely to have higher MRSA acquisition rate. Its effect further increased in wards receiving greater number of patients. In addition, critical care ward, presence of MRSA cohorting beds, ward specialty, and median length of stay were associated with MRSA acquisition.
format	article
author	Zaw Myo Tun Dale A Fisher Sharon Salmon Clarence C Tam
author_facet	Zaw Myo Tun Dale A Fisher Sharon Salmon Clarence C Tam
author_sort	Zaw Myo Tun
title	Ward-level factors associated with methicillin-resistant Staphylococcus aureus acquisition-an electronic medical records study in Singapore.
title_short	Ward-level factors associated with methicillin-resistant Staphylococcus aureus acquisition-an electronic medical records study in Singapore.
title_full	Ward-level factors associated with methicillin-resistant Staphylococcus aureus acquisition-an electronic medical records study in Singapore.
title_fullStr	Ward-level factors associated with methicillin-resistant Staphylococcus aureus acquisition-an electronic medical records study in Singapore.
title_full_unstemmed	Ward-level factors associated with methicillin-resistant Staphylococcus aureus acquisition-an electronic medical records study in Singapore.
title_sort	ward-level factors associated with methicillin-resistant staphylococcus aureus acquisition-an electronic medical records study in singapore.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/81be815bc462400bb6773463c9e42e47
work_keys_str_mv	AT zawmyotun wardlevelfactorsassociatedwithmethicillinresistantstaphylococcusaureusacquisitionanelectronicmedicalrecordsstudyinsingapore AT daleafisher wardlevelfactorsassociatedwithmethicillinresistantstaphylococcusaureusacquisitionanelectronicmedicalrecordsstudyinsingapore AT sharonsalmon wardlevelfactorsassociatedwithmethicillinresistantstaphylococcusaureusacquisitionanelectronicmedicalrecordsstudyinsingapore AT clarencectam wardlevelfactorsassociatedwithmethicillinresistantstaphylococcusaureusacquisitionanelectronicmedicalrecordsstudyinsingapore
_version_	1718375369628712960

Ward-level factors associated with methicillin-resistant Staphylococcus aureus acquisition-an electronic medical records study in Singapore.

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