Diabetes and early postpartum methicillin-resistant Staphylococcus aureus infection in US hospitals.

BACKGROUND

The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) infection in postpartum women is not well characterized. Because diabetes is a risk factor for some infections, we sought to characterize the relationship between diabetes and invasive MRSA infections in women admitted to US hospitals for delivery of an infant.

METHODS

We used data from the Nationwide Inpatient Sample, a representative sample of US community hospitals. Multivariate hierarchical logistic regression was used to estimate odds ratios (OR), adjusting for age, race, selected comorbidities, and expected payer, and hospital teaching status, urbanicity, bed size, geographic region, and ownership.

RESULTS

The odds ratio for prepregnancy diabetes was 3.4 (95% confidence interval: 1.9-6.0). The relationship remained strong after external adjustment for obesity (OR, 2.5; 95% CI: 1.3-4.8). The OR comparing women with complicated versus uncomplicated diabetes was 1.5 (95% CI: 0.3-6.0). We did not find an association with gestational diabetes (OR, 1.1; 95% CI: 0.7-1.7).

CONCLUSIONS

Prepregnancy diabetes, but not gestational diabetes, appears to be a risk factor for invasive MRSA infection in the early postpartum period. Women with diabetic complications may be at additional risk, but estimates were imprecise.