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The Impact of Household Transmission on Duration of Outpatient Colonization 3.10.09

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Leonard Davis Institute of Health Economics
Leonard Davis Institute of Health Economics

Author: Ebbing Lautenbach

Health & Medicine
1 of 1
The Impact of Household Transmission on Duration of Outpatient Colonization with Methicillin-Resistant Staphylococcus aureus (MRSA) Ebbing Lautenbach MD, MPH, MSCE, Pam Tolomeo MPH, Irving Nachamkin Dr PH, MPH, Baofung Hu MD, Theoklis E. Zaoutis, MD, MSCE University of Pennsylvania School of Medicine, Philadelphia, PA CONCLUSIONS POTENTIAL LIMITATIONS Background: The prevalence of MRSA has increased significantly in recent years. Although MRSA has become much more common in the community, few efforts have focused on rigorously assessing the duration of MRSA colonization in the community setting. Furthermore, the role of household spread in facilitating the duration of MRSA in outpatients has not been well studied. Objectives: To determine the duration of MRSA in individuals in the community and identify the impact of household MRSA transmission on duration of colonization. Methods: We identified consecutive adult patients presenting in the outpatient setting with skin and soft tissue infections (SSTIs) due to MRSA. These patients (i.e., index cases) and their household members were asked to participate in a longitudinal cohort study. Only those households in which all household members agreed to participate were enrolled. Index cases and their household members were asked to provide nares swabs every two weeks for three months. All nares swabs were plated on Chromagar MRSA to identify MRSA colonization. Results: Eight households were enrolled, comprising 15 subjects. There were three 1-person households, four 2-person households, and one 4-person household. The median age of subjects was 46 and 5 (33%) subjects were female. The mean duration of follow up was 58 days. In one household there was one household member positive for MRSA upon initial screening. There were also two additional households in which a new household member became newly colonized with MRSA during the longitudinal follow up. The mean duration of MRSA colonization among index cases was 33 days while the median duration of colonization among household members was 54 days. Of all 11 subjects who were colonized (8 index cases and 3 household members) 3 remained colonized at the end of follow up. There was a borderline significant association between having a concurrent colonized household member and a longer duration of MRSA colonization (p=0.08). Conclusions: MRSA colonization in the outpatient setting is often prolonged. Furthermore, we found that 60% (3 of 5) of multi-person households demonstrated multiple household members colonized with MRSA. Finally, MRSA colonization of a household member was associated with a prolonged duration of MRSA colonization in the index case. These results demonstrate that future research should focus on elucidating the epidemiology of household transmission of MRSA. ,[object Object],[object Object],[object Object],[object Object],[object Object],METHODS (cont) INTRODUCTION ABSTRACT METHODS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Ebbing Lautenbach, MD, MPH, MSCE 825 Blockley Hall, 423 Guardian Drive Philadelphia, PA 19104-6021 USA (215) 898-6977; ebbing@mail.med.upenn.edu ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],ACKNOWLEDGEMENTS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],OBJECTIVES ,[object Object],[object Object],[object Object],RESULTS

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