Nursing Homes as Reservoirs of MRSA: Myth or Reality?

Garazi, Michele; Edwards, Barbara; Caccavale, Donna; Auerbach, Charles; Wolf‐Klein, Gisele

doi:10.1016/j.jamda.2009.02.014

Cited by 32 publications

(32 citation statements)

References 16 publications

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“…In contrast to other studies, 12,13 a number of candidate risk factors we examined in this study did not achieve statistical significance at a 95% confidence level. For example, the increase in MRSA colonization predicted by our model in the presence of recent hospitalizations (acquisition rate: 0.034 to 0.056) or a wound (acquisition rate: 0.035 to 0.049) was substantial in absolute terms but did not achieve statistical significance.…”

Section: Discussioncontrasting

confidence: 99%

“…This finding is consistent with other studies which have found that recent antibiotic use increased nursing home resident risk of MRSA acquisition. 13,25 Antibiotics are among the most frequently prescribed medications in nursing homes 38 and much of this use is inappropriate. 38,39 Our findings in this study suggest that antibiotic stewardship 40 may represent a powerful tool to reduce the spread of MRSA in nursing homes.…”

Section: Discussionmentioning

confidence: 99%

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Models to predict prevalence and transition dynamics of methicillin-resistant Staphylococcus aureus in community nursing homes

Batina

Crnich

Anderson

et al. 2016

American Journal of Infection Control

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Background Recent spread of USA300 methicillin-resistant Staphylococcus aureus (MRSA) to nursing homes has been of particular concern. We sought to predict the ultimate prevalence of USA300 and non-USA300 MRSA and to examine the influence of potential risk factors on MRSA acquisition in community nursing homes. Methods The data was collected during a longitudinal MRSA surveillance study that involved 449 residents in six community nursing homes in Wisconsin. The subjects were screened every three months for up to one year. Markov chain models were employed to predict strain-specific prevalence of MRSA at steady state, and to assess the impact of potential risk factors, including recent hospitalizations, invasive medical devices, and antibiotic exposure on MRSA acquisition rates and average duration of colonization. Results At steady-state, 20% (95% CI, 15–25%) of residents were predicted to remain colonized with non-USA300 and 4% (95% CI, 2–7%) with USA300 MRSA. Residents who used antibiotics in the previous 3 months were twice more likely to acquire MRSA than those who did not (acquisition rates 0.052 (95% CI, 0.038–0.075) and 0.025 (95% CI, 0.018–0.037), respectively). Conclusions Non-USA300 was predicted to remain the dominant MRSA strain in community nursing homes. The higher rate of MRSA acquisition among residents with recent antibiotic exposure suggests that antibiotic stewardship may reduce MRSA colonization in this setting.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Models to predict prevalence and transition dynamics of methicillin-resistant Staphylococcus aureus in community nursing homes

Batina

Crnich

Anderson

et al. 2016

American Journal of Infection Control

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“…The MRSA prevalence we observed was lower than in MRSA surveys in recent years in the US [41][42][43][44][45], China [46], the UK [16], France [20], Ireland [15], and Italy [24], but higher than in the Netherlands and Sweden [14,22] (Table 3). …”

Section: Discussioncontrasting

confidence: 65%

Current prevalence of multidrug-resistant organisms in long-term care facilities in the Rhine-Main district, Germany, 2013

Hogardt

Proba

Mischler³

et al. 2015

Eurosurveillance

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Multidrug-resistant organisms (MDRO) and in particular multidrug-resistant Gram-negative organisms (MRGN) are an increasing problem in hospital care. However, data on the current prevalence of MDRO in long-term care facilities (LTCFs) are rare. To assess carriage rates of MDRO in LTCF residents in the German Rhine-Main region, we performed a point prevalence survey in 2013. Swabs from nose, throat and perineum were analysed for meticillin-resistant Staphylococcus aureus (MRSA), perianal swabs were analysed for extended-spectrum beta-lactamase (ESBL)-producing organisms, MRGN and vancomycin-resistant enterococci (VRE). In 26 LTCFs, 690 residents were enrolled for analysis of MRSA colonisation and 455 for analysis of rectal carriage of ESBL/MRGN and VRE. Prevalences for MRSA, ESBL/MRGN and VRE were 6.5%, 17.8%, and 0.4%, respectively. MRSA carriage was significantly associated with MRSA history, the presence of urinary catheters, percutaneous endoscopic gastrostomy tubes and previous antibiotic therapy, whereas ESBL/ MRGN carriage was exclusively associated with urinary catheters. In conclusion, this study revealed no increase in MRSA prevalence in LTCFs since 2007. In contrast, the rate of ESBL/MRGN carriage in German LTCFs was remarkably high. In nearly all positive residents, MDRO carriage had not been known before, indicating a lack of screening efforts and/or a lack of information on hospital discharge.

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“…Nursing homes, with their growing elderly residents, are ideal for its growth. [25–26] Places with overcrowding, such as prisons and dormitories, can facilitate the spread of MRSA. [27] Farm workers, especially those working with pigs, have apparently higher MRSA exposure.…”

Section: Predisposing Factorsmentioning

confidence: 99%

Revisiting methicillin-resistant Staphylococcus aureus infections

Waness

2010

J Global Infect Dis

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Within less than 50 years, methicillin-resistant Staphylococcus aureus (MRSA) made a tremendous impact worldwide. It is not limited to medical facilities and healthcare institutions anymore. Indeed since two decades, cases of MRSA infections arising from the community among apparently healthy individuals are increasing. In this paper, I will present a case of community-associated MRSA sepsis followed by a comprehensive review about the history, pathogenesis, epidemiology, clinical presentations, diagnostic modalities, therapeutic options, contributing factors, growing cost and other pertinent elements of this newly evolving epidemic of MRSA infections.

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Nursing Homes as Reservoirs of MRSA: Myth or Reality?

Cited by 32 publications

References 16 publications

Models to predict prevalence and transition dynamics of methicillin-resistant Staphylococcus aureus in community nursing homes

Models to predict prevalence and transition dynamics of methicillin-resistant Staphylococcus aureus in community nursing homes

Current prevalence of multidrug-resistant organisms in long-term care facilities in the Rhine-Main district, Germany, 2013

Revisiting methicillin-resistant Staphylococcus aureus infections

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