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International Archives of
Public Health and Community Medicine ISSN: 2643-4512

Citation

Smotherman C, Bilello L, Lukens-Bull K, Merten J, Wells S (2019) Opioid Dependence and Methicillin-Resistant Staphylococcus aureus (MRSA) Colonization or Infection in Hospitalized Patients in Florida: A Retrospective Study. Int Arch Public Health Community Med 3:017. doi.org/10.23937/iaphcm-2017/1710017

Copyright

© 2019 Smotherman C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ORIGINAL RESEARCH ARTICLE | OPEN ACCESS DOI: 10.23937/iaphcm-2017/1710017

Opioid Dependence and Methicillin-Resistant Staphylococcus aureus (MRSA) Colonization or Infection in Hospitalized Patients in Florida: A Retrospective Study

Carmen Smotherman1*, Lori Bilello2, Katryne Lukens-Bull3, Julie Merten4 and Saran Wells5

1Biostatistician, Center for Health Equity and Quality Research, University of Florida Health Jacksonville, USA

2Associate Director, Center for Health Equity and Quality Research, University of Florida Health Jacksonville, USA

3Clinical Research Manager, Center for Health Equity and Quality Research, University of Florida Health Jacksonville, USA

4Associate Professor, Department of Public Health, University of North Florida, USA

5Assistant Professor, Department of Pediatrics, University of Florida Health Jacksonville, USA

Abstract

Background

Prescriptions for opioid medications has increased during the past two decades. In 2016, there were 17,087 deaths involving prescription opioids, or approximately 46 deaths per day. This is a significant increase from 15,281 in 2015 (p < 0.05). The use of injectable opioids are often associated with skin infections, such as Methicillin-resistant Staphylococcus aureus (MRSA). The purpose of this study is to examine the association between opioid dependence and MRSA colonization or infection in hospitalized patients in Florida during 2009 - 2016.

Methods

Florida's Agency for Health Care Administration (AHCA) database was used for this study and includes discharge data from 299 hospitals in Florida. Patients 18 years or older with diagnoses of opioid dependence or MRSA infection or colonization were identified. Admissions to psychiatric and rehabilitation hospitals were not included in the analysis. Data was aggregated by the 11 Local Health Council (LHC) regions and includes all 67 counties.

Results

We examined more than 17 million hospitals admissions reported to AHCA between 2009 and 2016. We identified 177,752 (1.0%) admissions of patients with opioid dependence diagnosis, and 359,420 (2.1%) admissions of patients with MRSA. The rate of opioid dependence increased from 5.3 per 1,000 hospital admissions in 2009 to 16.6 in 2016. Substantial increases were evident in all LHC regions. MRSA infections were identified in 8,345 (4.7%) of the admissions of patients with opioid dependence, and in 351,075 (2.0%) of the patients without opioid dependence. The patients in opioid dependence group were 2.4 times more likely to have a MRSA diagnosis compared to the patients in non-opioid dependence group (OR = 2.38, 95% CI 2.33, 2.43, p < 0.001). Significant association between opioid dependence and MRSA was found in all LHC regions.

Conclusions

This study identified significant associations between opioid dependence and MRSA infection or colonization, overall, and in all LHC regions. Although preventive efforts such as screening, isolation, and handwashing are taking place in hospitals and communities, the findings illustrate the importance of implementing routine screening for MRSA in people with opioid dependence, as well in bringing awareness about MRSA transmission within communities.