[Methicillin-resistant Staphylococcus aureus in long-term care facilities for the aged in Frankfurt am Main, Germany, in 1999].
In recent years problems with multiple resistant bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) in hospitals have been increasing world-wide. Moreover, nursing home residents have also been found to be colonised with MRSA. In 1999, the Robert Koch Institute, Berlin inaugurated a multicenter study on the prevalence of MRSA colonisation in residents of old-age nursing homes in Germany. Here, the data from the city of Frankfurt will be reported.
With the informed consent of 359 residents from 7 old-age pensioners' homes and 42 patients of a geriatric rehabilitation unit, nasal and pharyngeal swaps were taken and tested for MRSA. Age, sex, duration of the stay in the home, former hospital admissions, acute and chronic diseases and medical devices such as urinary catheters were asked using a questionnaire. In addition including 150 employees (mainly nurses) of these institutions were tested for MRSA as well.


RESULTS
None of the employees tested were MRSA-positive. MRSA was found in 10 out of 401 residents/patients (2.4 %), i. e. 4.8 % of the patients and 2.2 % of the residents. As risk factors for colonisation of the residents could be found: male sex (Odds ratio 4.7, 95 % confidence interval 95CI 1.3-16.9), stay in the institution for less than 1 year (OR = 17.4; 95CI: 2.2-141) and former MRSA-colonisation (OR = 24.2; 95CI: 3.9-152). In addition, we got hints that former hospital admission was a risk factor for colonisation with MRSA (OR = 3; 95CI: 0.6-14.4). Residents with ulcus, decubiti and peripheral circulatory disorder were at double risk for MRSA colonisation (not significant).


CONCLUSIONS
The prevalence of MRSA colonisation in the residents of the old-age pensioners homes in Frankfurt am Main, Germany, was 2.4 %, which is (still?) low. There were no hints available for the spread of MRSA within the homes, although in 7 of 8 MRSA-positive residents MRSA colonisation was not known previously, so that no special hygienic regime was applied. Therefore, US-American and British guidelines for the control of MRSA in nursing homes were confirmed: a good hygienic regime, especially correct hand hygiene is the most important measure to prevent the spread of MRSA within the nursing homes. In general, isolation of the colonised residents is not necessary, unless in very special individual cases.
Heudorf
U
U
Abteilung Umweltmedizin und Hygiene, Stadtgesundheitsamt Frankfurt, Frankfurt am Main. ursel.heudorf@stadt-frankfurt.de
Bremer
V
V
Heuck
D
D
D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000188:drug therapy / Q000635:transmission*; D003430:Cross-Sectional Studies; D018432:Drug Resistance, Multiple; D005260:Female; D005858:Germany; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000635:transmission*; D013211:Staphylococcus aureus / Q000187:drug effects
MRSA-Besiedelung bei Bewohnern von Alten- und Pflegeheimen sowie bei Patienten einer geriatrischen Rehabilitationsklinik in Frankfurt am Main, 1999.