Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-23T08:14:00.457Z Has data issue: false hasContentIssue false
  • English
  • Français

Risk Factors for Methicillin-Resistant Staphylococcus Aureus Carriage in Residents of German Nursing Homes

Published online by Cambridge University Press:  02 January 2015

H. von Baum ,
C. Schmidt ,
D. Svoboda ,
O. Bock-Hensley  and
Constanze Wendt
H. von Baum
Affiliation:
Hygiene-Institut, University of Heidelberg, Heidelberg, Germany
C. Schmidt
Affiliation:
Hygiene-Institut, University of Heidelberg, Heidelberg, Germany
D. Svoboda
Affiliation:
Hygiene-Institut, University of Heidelberg, Heidelberg, Germany
O. Bock-Hensley
Affiliation:
Landratsamt Rhine-Neckar-Kreis, Gesundheitsamt, Heidelberg, Germany
Constanze Wendt*
Affiliation:
Hygiene-Institut, University of Heidelberg, Heidelberg, Germany
*
Hygiene-Institut, University of Heidelberg, INF 324, 69 120 Heidelberg, Germany
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To determine the prevalence of and the risk factors for methicillin-resistant Staphylococcus aureus (MRSA) carriage in nursing home residents in the Rhine-Neckar region of southern Germany.

Design:

Point-prevalence survey.

Setting:

Forty-seven nursing homes in the region.

Participants:

All residents of the approached nursing homes who agreed to participate.

Methods:

After informed consent was obtained, all participants had their nares swabbed, some personal data collected, or both. All swabs were examined for growth of MRSA All S. aureus isolates underwent oxacillin susceptibility testing and polymerase chain reaction for demonstration of the meek gene. All MRSA isolates were typed using pulsed-field gel electrophoresis after digestion with SmaI.

Results:

Swabs from 3,236 nursing home residents yielded 36 MRSA strains, contributing to a prevalence rate of 1.1%. Significant risk factors for MRSA carriage in the multivariate analysis were the presence of wounds or urinary catheters, limited mobility, admission to a hospital during the preceding 3 months, or stay in a medium-size nursing home. One predominant MRSA strain could be detected in 30 of the 36 MRSA carriers.

Conclusions:

The prevalence of MRSA in German nursing homes is still low. These residents seemed to acquire their MRSA in the hospital and transfer it to their nursing home. Apart from well-known risk factors for the acquisition of MRSA we identified the size of the nursing home as an independent risk factor. This might be due to an increased use of antimicrobials in nursing homes of a certain size.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 9 , September 2002 , pp. 511 - 515
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Goettsch, W, Geubbels, E, Wannet, W, et al. MRSA in nursing homes in The Netherlands, 1989 to 1998: a developing reservoir? Eurosurveillance 2000;5:28–31.Google Scholar
2.Cox, RA, Bowie, PES. Methicillin-resistant Staphylococcus aureus colonization in nursing home residents: a prevalence study in Northhamptonshire. J Hosp Infect 1999;43:115–122.Google Scholar
3.Strausbaugh, LJ, Jacobson, C, Sewell, DL, et al. Methicillin-resistant Staphylococcus aureus in extended-care facilities: experiences in a veterans' affairs nursing home and a review of the literature. Infect Control Hosp Epidemiol 1991;12:36–45.CrossRefGoogle Scholar
4.Hsu, CCS. Serial survey of methicillin-resistant Staphylococcus aureus nasal carriage among residents in a nursing home. Infect Control Hosp Epidemiol 1991;12:416–421.Google Scholar
5.O'Sullivan, NP, Keane, CT. The prevalence of methicillin-resistant Staphylococcus aureus among residents of six nursing homes for the elderly. J Hosp Infect 2000;45:322–329.Google Scholar
6.Heuck, D, Fell, G, Hamouda, O, et al. Erste Ergebnisse einer überregionalen Studie zur MRSA-Besiedlung bei Bewohnern von Alten-und Pflegeheimen. Hygiene & Medizin 2000;5:191–192.Google Scholar
7.Ruoff, KL. Staphylococcus. In: Murray, PR, Baron, EJ, Kaller, MA, Tenover, FC, Yolken, RH, eds. Manual of Clinical Microbiology, 6th ed. Washington, DC: American Society for Microbiology; 1995:299–307.Google Scholar
8.Schmitz, F-J, MacKenzie, CR, Hofmann, B, et al. Specific information concerning taxonomy, pathogenicity and methicillin-resistance of staphylococci obtained by a multiplex PCR. J Med Microbiol 1997;46:773–778.Google Scholar
9.Pfaller, M, Hollis, RJ, Sader, HS. PFGE of chromosomal DNA. In: Isenberg, HD, ed. Clinical Microbiological Procedures Handbook. Washington, DC: American Society for Microbiology; 1992:Section 10.5.C.Google Scholar
10.Hauner, H, Kurnaz, AA, Groschopp, C, Haastert, B, Feldhoff, KH, Scherbaum, WA. Management of diabetic patients in inpatient nursing care facilities in the Hamburg district. Medizinische Klinik 2000;95:608–612.Google Scholar
11.Peet, SM, Castleden, CM, McGrother, CW. Prevalence of urinary and faecal incontinence in hospitals and residential and nursing homes for older people. BMJ 1995;311:1063–1064.CrossRefGoogle ScholarPubMed
12.Martin, U, Behler, R. Duisburger Modell-intensivierte Heimaufsicht des Gesundheitsamtes in Zusammenarbeit mit dem Sozialamt. Gesundheitswesen 1999;1999:337–339.Google Scholar
13.Coello, R, Jimenez, J, Garcia, M, et al. Prospective study of infection, colonization and carriage of methicillin-resistant Staphylococcus aureus in an outbreak affecting 990 patients. Eur J Clin Microbiol Infect Dis 1994; 13:74–81.Google Scholar
14.Bradley, SF. Methicillin-resistant Staphylococcus aureus in nursing homes: epidemiology, prevention and management. Drugs Aging 1997; 10:185–198.Google Scholar
15.Strausbaugh, LJ, Crossley, KB, Nurse, BA, Thrupp, LD. Antimicrobial resistance in long-term-care facilities. Infect Control Hosp Epidemiol 1996;17:129–140.CrossRefGoogle ScholarPubMed
16.Bradley, SF. Methicillin-resistant Staphylococcus aureus: long-term care concerns. Am J Med 1999;106(suppl):2S–10S.CrossRefGoogle ScholarPubMed
17.Trick, WE, Weinstein, RA, DeMarais, PL, et al. Colonization of skilled-care facility residents with antimicrobial-resistant pathogens. J Am Geriatr Soc 2001;49:270–276.CrossRefGoogle ScholarPubMed
18.O'Sullivan, NP, Keane, CT. Risk factors for colonization with methicillin-resistant Staphylococcus aureus among nursing home residents. J Hosp Infect 2000;45:206–210.Google Scholar
19.Coello, R, Glynn, J, Gaspar, C, Picazo, JJ, Fereres, J. Risk factors for developing clinical infection with methicillin-resistant Staphylococcus aureus (MRSA) amongst hospital patients initially only colonized with MRSA. J Hosp Infect 1997;37:39–46.Google Scholar
20.Asensio, A, Guerrero, A, Quereda, C, Lizan, M, Martinez-Ferrer, M. Colonization and infection with methicillin-resistant Staphylococcus aureus: associated factors and eradication. Infect Control Hosp Epidemiol 1996;17:20–28.Google Scholar
21.Scudeller, L, Leoncini, O, Boni, S, et al. MRSA carriage: the relationship between community and healthcare setting: a study in an Italian hospital. J Hosp Infect 2000;46:222–229.Google Scholar
22.Murphy, S, Denman, S, Bennett, RG, Greenough, WB 3rd, Lindsay, J, Zalesnick, LB. Methicillin-resistant Staphylococcus aureus colonization in a long-term-care facility. J Am Geriatr Soc 1992;40:213–217.Google Scholar
23.Troillet, N, Carmeli, Y, Samore, MH, et al. Carriage of methicillin-resistant Staphylococcus aureus at hospital admission. Infect Control Hosp Epidemiol 1998;19:181–185.CrossRefGoogle ScholarPubMed
24.Crowcroft, N, Maguire, H, Fleming, M, Peacock, J, Thomas, J. Methicillin-resistant Staphylococcus aureus: investigation of a hospital outbreak using a case-control study. J Hosp Infect 1996;34:301–309.Google Scholar
25.Dziekan, G, Hahn, A, Thüne, K, et al. Methicillin-resistant Staphylococcus aureus in a teaching hospital: investigation of nosocomial transmission using a matched case-control study. J Hosp Infect 2000;46:263–270.Google Scholar
26.Coll, PP, Crabtree, BF, O'Connor, PJ, Klenzak, S. Clinical risk factors for methicillin-resistant Staphylococcus aureus bacteriuria in a skilled-care nursing home. Arch Fam Med 1994;3:357–360.Google Scholar
27.Warshawsky, B, Hussain, Z, Gregson, DB, et al. Hospital- and community-based surveillance of methicillin-resistant Staphylococcus aureus: previous hospitalization is the major risk factor. Infect Control Hosp Epidemiol 2000;21:724–727.Google Scholar
28.Mylotte, JM, Karuza, J, Bentley, DW. Methicillin-resistant Staphylococcus aureus: a questionnaire survey of 75 long-term care facilities in western New York. Infect Control Hosp Epidemiol 1992;13:711–718.Google Scholar
29.Wendt, C, Krause, C, Xander, L, Loffler, D, Floss, H. Prevalence of colonisation with vancomycin-resistant enterococci (VRE) in various population groups in Berlin, Germany. J Hosp Infect 1999;42:193–200.Google Scholar
30. Anonymous. Auszüge aus dem Jahresbericht des Nationalen Refenzzentrums für Staphlyococcen am Robert Koch-Institut Epidemiol. Epidemiologisches Bulletin 2002;8:61–63.Google Scholar