Incidence of Methicillin-Resistant Staphylococcus Aureus (MRSA) Isolation in a Skilled Nursing Home : A Third Report on the Risk Factors for the Occurrence of MRSA Infection in the Elderly

Abstract

A case control study was carried out in order to evaluate the various factors which may influence the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) infections in a skilled nursing home. From April 1991 to March 1994, bacterial cultures were performed in 55 out of 102 residents in a nursing home based on various clinical aspects.We divided 102 residents into following three groups ; (1) the MRSA group (n=1 0), residents whose materials for bacterial culture were positive for MRSA, (2) the non-MRSA group (n=45), residents whose specimens were negative for MRSA but positive for other bacteria, (3) the control group (n=47), residents who did not have to undergo a bacterial culture because they were free from moderate and severe infectious diseases.Compared with the control group, the activities of daily living score and the serum albumin level were significantly lower in the MRSA group and the non-MRSA group at the beginning of the study. In contrast, the number of antibiotics used prior to the bacterial culture and the proportion of hospitalization within 6 months prior to the bacterial culture were significantly larger in the MRSA group than in either the non-MRSA group, or the control group. These results thus suggest that a low activities of daily living score, the use of many kinds of antibiotics and a recent previous hospitalization may be risk factors of MRSA infection in a nursing home environment.

Indicators of Potentially Drug-Resistant Bacteria in Severe Nursing Home--Acquired Pneumonia

“…The association between functional status and increased likelihood of bacterial resistance has been documented in previous investigations [17,23,25]. Patients with poorer functional status are more likely to be exposed to cross-contamination of bacteria through increased requirements for patient care.…”

“…These indicators are not limited to a resistant-specific pathogen. Most of the previously published predictive indices have been linked to either MRSA, P. aeruginosa, or vancomycinresistant enterococci [23,25]. In comparison, the present model relies on variables with characteristics common to all subjects with infection or colonization by DRPs.…”

Changing epidemiology of methicillin-resistant Staphylococcus aureus in Finland

“…Risk factors that may influence the occurrence of MRSA infection in long-term care facilities include a recent previous hospitalization, the use of broad-spectrum antibiotics, limited mobility and the presence of urinary catheters and wounds. 13,14 A limitation of this study was that the clinical data and risk factors for MRSA acquisition in Finnish long-term care facilities were not available, and that the survey on MRSA in long-term care facilities only covered one year. It is generally known that clinical infections are rarer in long-term care than in acute-care hospitals, 15 and we assume that most MRSA isolated in Finnish long-term care facilities was from screening specimens.…”

Methicillin-Resistant Staphylococcus Aureus (MRSA) Isolation from Pharyngeal Swab Cultures of Japanese Elderly at Admission to a Geriatric Hospital.

“…The ADL score was determined in the same manner as in our previous studies r. 7,8,9,10,11,12). The ADL score was the sum of the ability to perform ADL.…”