Lower social class linked to increased risk of postoperative MRSA infection

Results of a UK study in this week's issue of The Lancet suggest that people from the poorest socioeconomic backgrounds could be up to seven times more likely to get postoperative infection with meticillin-resistant Staphylococcus aureus (MRSA) than people from affluent social groups. This heightened risk is more likely to be a result of increased hospital visits rather than due to community-based MRSA infection.

A link between social status and postoperative outcomes has not previously been reported. Jens Peder Bagger from Hammersmith Hospital and Imperial College, London, UK, categorised over 1700 patients undergoing coronary artery bypass grafting into socioeconomic groups based on patients' postcodes. 23 patients (1.3%) developed MRSA infection after surgery (not an unexpected proportion of infection). Patients from the most deprived areas had a seven-fold higher infection rate (13 of 579 [2.2%] ) than those from the least deprived areas (two of 580) [0.3%].

Patients with MRSA infection had a six-fold higher death rate and a longer hospital stay than patients with no MRSA infection.

Dr Bagger comments: "About half of our patients (12 of 23) with postoperative MRSA had been transferred from another hospital or department or had been admitted to hospital in the preceding 6 months. The resistance pattern suggests that the MRSA strains are more likely to be associated with hospitals than to originate from the community." He concludes that the study has identified "a target group for further monitoring and intervention to reduce this serious postoperative complication."

Contact: Dr Jens Peder Bagger, Hammersmith Hospital, Du Cane Road, London W12 OHS, UK;
T) 44-208-383-3171;
F) 44-208-740-8373;
E) p.bagger@ic.ac.uk

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