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Methicillin-resistant Staphylococcus aureus (MRSA) in the institutionalized older patient

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  14 September 2009

M Eveillard  and
ML Joly-Guillou
M Eveillard*
Affiliation:
Laboratoire de Bactériologie-hygiène, Centre Hospitalier Universitaire, Angers, France
ML Joly-Guillou
Affiliation:
Laboratoire de Bactériologie-hygiène, Centre Hospitalier Universitaire, Angers, France
*
Address for correspondence: M Eveillard, Laboratoire de Bactériologie-hygiène, CHU Angers, 4 rue Larrey, F-49000, France. Email: [email protected]
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Summary

Nursing homes and long-term care facilities are usually considered as reservoirs for methicillin-resistant Staphylococcus aureus (MRSA) carriers. Actually, there are major differences in MRSA carriage between institutions, with variations from 1% to more than 30%. Overall there is a low incidence of MRSA infection in these institutions, even though carriage is associated with a higher risk of subsequent MRSA infection, with high mortality rates. The main risk factors for carriage are well known: recent hospitalization in an acute-care ward, skin wounds and recent antimicrobial therapy. Age over 75 years is also a risk factor. Residents of nursing homes and long-term care facilities pose a risk of MRSA transfer to acute-care wards, with potential consequences in terms of infection control strategy or surgical antibiotic prophylaxis. No well-designed study has identified the best strategy for MRSA control in institutions for older people and strategies that have been proposed are controversial. Studies to elucidate this would be useful, as well as studies specifically designed to identify the relative importance of different ways of MRSA transmission in these institutions (cross-transmission via healthcare workers or the environment, or direct transmission from one resident to another). Finally, a first important step towards MRSA control is a strict application of standard precautions, particularly good compliance with hand hygiene.

Keywords

Older peoplenursing homeslong-term care facilitiesmethicillin-resistant Staphylococcus aureusMRSA
Type
Clinical geriatrics
Information
Reviews in Clinical Gerontology , Volume 19 , Issue 1 , February 2009 , pp. 13 - 23
Copyright
Copyright © Cambridge University Press 2009

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