A reservoir for methicillin-resistant Staphylococcus aureus in the Auckland community?
OBJECTIVE
To determine if there is a difference in methicillin-resistant Staphylococcus aureus (MRSA) colonisation rates between patients over the age of 60 years admitted to Auckland Hospital from either residential care facilities (RCF) or the community.


METHODS
A prospective cohort study. The following information was collected: patient demographics; admission in the last 12 months; presence of risk factors for MRSA colonisation; any history of MRSA colonisation. Swabs from the nose, perineum and any infected wounds or skin lesions were collected. Urine was cultured if the patient had a urinary catheter in situ.


RESULTS
19 (9%) patients of 213 from RCF, and 6 (3%) patients of 201 from the community were positive for MRSA (p = 0.02). Patients admitted to hospital in the previous 12 months were three times more likely to be colonised with MRSA than others (p = 0.01). Excluding those patients already known to be MRSA positive, patients admitted from RCF were six times more likely to be newly found to be MRSA positive. Twenty four of the 25 MRSA isolates were EMRSA-15.


CONCLUSIONS
Patients from RCF are statistically more likely to be colonised with MRSA compared with patients of similar age admitted from the community. Identification of such high-risk carriers allows targeted infection control activity to control MRSA within hospitals.
Briggs
Simon
S
Department of Microbiology, Auckland District Health Board.
McGuiness
Camilla
C
Foster
Michelle
M
Roberts
Sally
S
D000368:Aged; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000453:epidemiology; D016001:Confidence Intervals; D003428:Cross Infection / Q000453:epidemiology*; D004197:Disease Reservoirs / Q000706:statistics & numerical data*; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D009735:Nursing Homes / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D014546:Urinary Catheterization / Q000009:adverse effects