Studie zum Vorkommen von Methicillin-resistenten Staphylococcus aureus in Alten- und Altenpflegeheimen in Nordrhein-Westfalen

Neuhaus, Barbara; Bocter, N.; Braulke, Ch.; Heuck, C. C.; Witte, Wilfried

doi:10.1007/s00103-002-0521-1

Cited by 16 publications

(9 citation statements)

References 9 publications

(21 reference statements)

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“…Overall, in this study 4.8% LTCF residents were found to be MRSA positive. This MRSA prevalence rate in LTCF residents is inferior to rates reported in previous LTCF studies from Germany such as one from the Frankfurt/Main area (9.0%, 9.2%, and 6.2% in studies from 2006, 2012, and 2013, respectively) [ 34 – 36 ] or Brunswick (7.6% in 2009) [ 37 ], but it is clearly higher than reported in a study from North Rhine-Westphalia (3%) [ 38 ] and from the Rhine-Neckar region (1.1%) [ 33 ] (both studies from year 2000). Compared to international studies, the MRSA prevalence rate in our study was also found to be inferior than reported in studies from the USA (24% 1998, 6.3% 2003, and 31% in 2008, respectively) [ 39 – 41 ], from Hong Kong (21.6% in 2011) [ 42 ], or Luxembourg (7.2% in 2010) [ 43 ], but larger than in geriatric and/or rehabilitative wards of hospitals in the Dutch-German border area (2.6% in 2006) [ 44 ], in the Netherlands (0.3% in 2009) [ 45 ], or in Sweden (0% in 2012) [ 46 ].…”

Section: Discussioncontrasting

confidence: 57%

“…One smaller study from 2002 in nursing homes in North Rhine-Westphalia revealed one MRSA positive for approximately every 16 S . aureus positive residents (MRSA rate 6.3%) [ 38 ]. Interestingly, findings from acute care institutions (e.g., the German counties participating in the Euregio study [ 44 ]) detected 6.5% of methicillin resistant isolates, while the AP study in Saarland [ 1 ] revealed a rate of 14.0%.…”

Section: Discussionmentioning

confidence: 99%

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Methicillin-Resistant Staphylococcus aureus in Saarland, Germany: The Long-Term Care Facility Study

et al. 2016

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BackgroundMultiresistant organisms pose a threat for patients and care recipients. Control interventions need to be tailored to region, the type of institution considered, and risk factors. The German state of Saarland is ideally suited to study colonisation epidemiology throughout its various health and care institutions. After conclusion of a large admission prevalence study in acute care hospitals, we now performed a methicillin-resistant Staphylococcus aureus (MRSA) point prevalence study in Saarland long term care facilities (LTCF), allowing for a direct comparison with respect of MRSA prevalence and associated risk factors between these two institutional types located within a confined region.Methodology and Principal FindingsOf all LTCF of the region, 65/136 participated in the study performed between 09/2013 and 07/2014. Overall, complete microbiological specimen and questionnaires of 2,858 of 4,275 (66.8%) LTCF residents were obtained. 136/2,858 (4.8%) screened residents revealed MRSA carrier status. Multivariate risk factor analysis yielded ulcer/deep soft tissue infection, urinary tract catheter, and MRSA history with multiple MRSA decolonisation cycles to be independently associated with MRSA carrier status.ConclusionAs already known from previous studies, colonisation with MRSA is common in LTCF residents even in an area with relatively low MRSA prevalence. This found prevalence can now be related to the acute care admission prevalence (2.2%) as well as to the admission prevalence in acute care geriatric departments (7.6%). The common clonal attribution (spa type) of MRSA isolates prevalent in the LTCF population as well as in the acute care admission population points towards a close relationship between both types of institutions. However, the ostensible absence of risk factors such as “previous hospitalisation” in conjunction with newly identified factors such as “multiple decolonisation cycles” refers to MRSA colonisation risks independent of contact with acute care facilities. Overall, this large LTCF point prevalence study allows data-based, region-tailored decisions on MRSA screening policies and provides a basis for additional preventative measures.

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Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Methicillin-Resistant Staphylococcus aureus in Saarland, Germany: The Long-Term Care Facility Study

et al. 2016

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“…The point prevalence of MRSA colonisation was 6.5% and thus much higher than in earlier studies in 2000-01 in Germany [8,9,11,13], but since 2007, the MRSA prevalence in LTCFs in Germany has not increased further and remained between 6.5% and 9.2% [7,10,12].…”

Section: Discussionmentioning

confidence: 62%

“…MDRO are regarded as a potentially serious threat to elderly people living in long-term care facilities (LTCFs). Although various studies on the prevalence of MRSA in LTCFs in Germany [7][8][9][10][11][12][13] and other European countries [14][15][16][17][18][19][20][21][22][23][24][25] have been published (< 1% in the Netherlands and Sweden, > 20% in Ireland and the United Kingdom (UK)), studies on the prevalence of MRGN such as extended-spectrum betalactamase (ESBL)-producing Enterobacteriaceae and vancomycin-resistant enterococci (VRE) among nursing home residents in German and in European LTCFs are scarce [7,14,24,26,27]. Although an increasing trend in the occurrence of ESBL-producing Enterobacteriaceae and even CRO is found in hospitals all over Europe [1,3,28,29], a lack of knowledge on multidrug-resistant organisms (MDRO) in nursing homes has to be stated.…”

Section: Introductionmentioning

confidence: 99%

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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“…Epidemiologische Studien, die sich mit der Kolonisation von Altenheimbewohnern mit mehrfach-resistenten Erregern beschäf-tigen, sind erst in der jüngeren Vergangenheit initiiert worden und haben sich meist auf MRSA oder VRE fokussiert. Für MRSA bei deutschen Altenheimbewohnern sind teils relativ niedrige Kolonisationsraten zwischen 1,1% und 3%, teils aber auch höhere Prävalenzen von 7,6% veröffentlicht [37,38,39,40]. Genetische Analysen zeigen, dass es sich dabei in der Regel um Stämme handelt, die auch in Krankenhäusern prävalent sind [41].…”

Section: Bedeutung Antibiotikaresistenter Bakterien Bei Alten Menscheunclassified

Herausforderungen durch Infektionen und mehrfach-resistente Bakterien bei alten Menschen in Heimen

Ruscher

Schaumann

Mielke

2012

Bundesgesundheitsbl.

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Studie zum Vorkommen von Methicillin-resistenten Staphylococcus aureus in Alten- und Altenpflegeheimen in Nordrhein-Westfalen

Cited by 16 publications

References 9 publications

Methicillin-Resistant Staphylococcus aureus in Saarland, Germany: The Long-Term Care Facility Study

Methicillin-Resistant Staphylococcus aureus in Saarland, Germany: The Long-Term Care Facility Study

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

Herausforderungen durch Infektionen und mehrfach-resistente Bakterien bei alten Menschen in Heimen

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