Methicillin-resistant Staphylococcus Aureus in Canadian Hospitals from 1995 to 2007: A Comparison of Adult and Pediatric Inpatients
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Université d'Ottawa / University of Ottawa
Abstract
The literature directly comparing the epidemiology of MRSA among adult and pediatric hospitalized patients is strikingly minimal. The objective of this thesis was to identify any differences between these two patient groups. The Canadian Nosocomial Infections Surveillance Program MRSA data (1995 to 2007: n=1,262 pediatric and 35,907 adult cases) were used to compare MRSA clinical and molecular characteristics and rates. Hospital characteristics were modeled using repeated measures Poisson regressions. The molecular and epidemiological characteristics of MRSA differed significantly between adults and children. Compared to children, MRSA in adults was more likely to be healthcare-associated, colonization, SCCmec type II, PVL negative, and resistant to most antibiotics. Rates of MRSA in Canada increased in both populations over time but were significantly higher in adults. The hospital characteristics associated with increased MRSA rates differed in adult and pediatric facilities. Implications for infection prevention and control strategies are discussed.
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Methicillin-Resistant Staphylococcus aureus, Epidemiology, Humans, Cross Infection, Hospitals, Drug resistance, antimicrobial, Infant, Child, Infant, newborn, Child, preschool, Age factors, Sentinel Surveillance, Population Surveilance, Canada, Hospitals, pediatric, Community-Acquired Infections, Hospitalization, Methicillin Resistance, Incidence, Molecular Epidemiology, Molecular Typing, Cluster Analysis, Staphylococcal Infection/epidemiology, Healthcare Associated Infections, Panton-Valentine leukocidin, Age Groups, Adult, Aged, Nosocomial Infections, MRSA, Adolescent, Aged, 80 and over, Young adult, Drug Resistance, Multiple, Bacterial, Infection Control, Infection Control Practitioners, Hospital Bed Capacity, Bed Occupancy, Pediatrics, Epidemiologic Factors, Health Facilities, Risk Factors, Length of Stay, Patient Admission, Staphylococcus aureus, Canadian Nosocomial Infections Surveillance Program, Public Health Agency of Canada