Risk factors for methicillin-resistant Staphylococcus aureus carriage in residents of German nursing homes.
OBJECTIVE
To determine the prevalence of and the risk factors for methicillin-resistant Staphylococcus aureus (MRSA) carriage in nursing home residents in the Rhine-Neckar region of southern Germany.


METHODS
Point-prevalence survey.


METHODS
Forty-seven nursing homes in the region.


METHODS
All residents of the approached nursing homes who agreed to participate.


METHODS
After informed consent was obtained, all participants had their nares swabbed, some personal data collected, or both. All swabs were examined for growth of MRSA. All S. aureus isolates underwent oxacillin susceptibility testing and polymerase chain reaction for demonstration of the mecA gene. All MRSA isolates were typed using pulsed-field gel electrophoresis after digestion with SmaI.


RESULTS
Swabs from 3,236 nursing home residents yielded 36 MRSA strains, contributing to a prevalence rate of 1.1%. Significant risk factors for MRSA carriage in the multivariate analysis were the presence of wounds or urinary catheters, limited mobility, admission to a hospital during the preceding 3 months, or stay in a medium-size nursing home. One predominant MRSA strain could be detected in 30 of the 36 MRSA carriers.


CONCLUSIONS
The prevalence of MRSA in German nursing homes is still low. These residents seemed to acquire their MRSA in the hospital and transfer it to their nursing home. Apart from well-known risk factors for the acquisition of MRSA, we identified the size of the nursing home as an independent risk factor. This might be due to an increased use of and microbials in nursing homes of a certain size.
von Baum
H
H
Hygiene-Institut, University of Heidelberg, Germany.
Schmidt
C
C
Svoboda
D
D
Bock-Hensley
O
O
Wendt
Constanze
C
D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins; D002352:Carrier Proteins / Q000235:genetics; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology* / Q000635:transmission; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology* / Q000635:transmission; D004269:DNA, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005858:Germany / Q000453:epidemiology; D006276:Health Facility Size; D006602:Hexosyltransferases; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D017053:Infection Control; D008297:Male; D016106:Methicillin Resistance / Q000235:genetics; D015999:Multivariate Analysis; D002267:Muramoylpentapeptide Carboxypeptidase / Q000235:genetics; D009735:Nursing Homes / Q000706:statistics & numerical data*; D046915:Penicillin-Binding Proteins; D010458:Peptidyl Transferases; D016133:Polymerase Chain Reaction; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000635:transmission; D013211:Staphylococcus aureus / Q000235:genetics
D001426:Bacterial Proteins; D002352:Carrier Proteins; D004269:DNA, Bacterial; D046915:Penicillin-Binding Proteins; D010458:Peptidyl Transferases; D006602:Hexosyltransferases; D002267:Muramoylpentapeptide Carboxypeptidase