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Infectious Diseases in Obstetrics and Gynecology
Volume 2014, Article ID 515646, 6 pages
http://dx.doi.org/10.1155/2014/515646
Research Article

Predischarge Postpartum Methicillin Resistant Staphylococcus aureus Infection and Group B Streptococcus Carriage at the Individual and Hospital Levels

1Department of Health Policy and Management, UCLA Fielding School of Public Health, 650 Charles E. Young Drive S., 31-269 CHS, Los Angeles, CA 90095, USA
2Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive S., 71-236 CHS, Los Angeles, CA 90095, USA
3Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, 50 Beale Street, San Francisco, CA 94105, USA
4UCLA Center for Health Policy Research, 10960 Wilshire Boulevard No. 1550, Los Angeles, CA 90024, USA
5Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1100 DE Amsterdam, The Netherlands

Received 28 October 2013; Accepted 1 February 2014; Published 6 March 2014

Academic Editor: Ann Duerr

Copyright © 2014 Andrea M. Parriott et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. We sought to characterize the relationship between individual group B streptococcus (GBS) colonization and pre-discharge postpartum methicillin resistant Staphylococcus aureus (MRSA) infection in United States women delivering at term. We also sought to examine the association between hospital GBS colonization prevalence and MRSA infection. Materials and Methods. Data was from the Nationwide Inpatient Sample, a representative sample of United States community hospitals. Hierarchical regression models were used to estimate odds ratios adjusted for patient age, race, expected payer, and prepregnancy diabetes and hospital teaching status, urbanicity, ownership, size, and geographic region. We used multiple imputation for missing covariate data. Results. There were 3,136,595 deliveries and 462 cases of MRSA infection included in this study. The odds ratio for individual GBS colonization was 1.2 (95% confidence interval: 0.9 to 1.5). For a five-percent increase in the hospital prevalence of GBS colonization, the odds ratio was 0.9 (95% CI: 0.1 to 5.6). Conclusions. The odds ratio estimate for the association of hospital GBS prevalence with MRSA infection is too imprecise to make conclusions about its magnitude and direction. Barring major bias in our estimates, individual GBS carriage does not appear to be strongly associated with predischarge postpartum MRSA infection.