Department of Internal Medicine, University of Iowa, Iowa City, IA, USA.
Department of Biostatistics, University of Iowa, Iowa City, IA, USA.
Infect Control Hosp Epidemiol. 2024 Jul;45(7):826-832. doi: 10.1017/ice.2024.106. Epub 2024 Aug 7.
Estimate the risk for household transmission of Methicillin-Resistant Staphylococcus aureus (MRSA) following exposure to infected family members or family members recently discharged from a hospital.
Analysis of monthly MRSA incidence from longitudinal insurance claims using the Merative MarketScan Commercial and Medicare (2001-2021) databases.
Visits to inpatient, emergency department, and outpatient settings.
Households with ≥2 family members enrolled in the same insurance plan for the entire month.
We estimated a monthly incidence model, where enrollees were binned into monthly enrollment strata defined by demographic, patient, and exposure characteristics. Monthly incidence within each stratum was computed, and a regression analysis was used to estimate the incidence rate ratio (IRR) associated with household exposures of interest while accounting for potential confounding factors.
A total of 157,944,708 enrollees were included and 424,512 cases of MRSA were identified. Across all included enrollees, exposure to a family member with MRSA in the prior 30 days was associated with significantly increased risk of infection (IRR: 71.03 [95% CI, 67.73-74.50]). After removing enrollees who were hospitalized or exposed to a family member with MRSA, exposure to a family member who was recently discharged from the hospital was associated with increased risk of infection (IRR: 1.44 [95% CI, 1.39-1.49]) and the risk of infection increased with the duration of the family member's hospital stay ( value < .001).
Exposure to a recently hospitalized and discharged family member increased the risk of MRSA infection in a household even when the hospitalized family member was not diagnosed with MRSA.
估计接触感染的家庭成员或最近出院的家庭成员后，耐甲氧西林金黄色葡萄球菌（MRSA）在家庭中的传播风险。
使用 Merative MarketScan 商业和医疗保险（2001-2021 年）数据库，对纵向保险索赔中每月 MRSA 发病率进行分析。
住院、急诊和门诊就诊。
同一保险计划中家庭成员≥2 的家庭。
我们估计了每月的发病率模型，其中参保者按人口统计学、患者和暴露特征划分为每月的参保分层。计算每个分层内的每月发病率，并使用回归分析来估计与家庭暴露相关的发病率比（IRR），同时考虑潜在的混杂因素。
共纳入 157944708 名参保者，发现 424512 例 MRSA 病例。在所有纳入的参保者中，在过去 30 天内接触携带 MRSA 的家庭成员与感染风险显著增加相关（IRR：71.03 [95%CI，67.73-74.50]）。在去除住院或接触携带 MRSA 的家庭成员的参保者后，接触最近出院的家庭成员与感染风险增加相关（IRR：1.44 [95%CI，1.39-1.49]），且感染风险随家庭成员住院时间的延长而增加（<.001）。
即使住院的家庭成员未被诊断为 MRSA，接触最近住院和出院的家庭成员也会增加家庭中 MRSA 感染的风险。
