Staphylococcus aureus carrier state among elderly residents of a long-term care facility.
BACKGROUND
Methicillin-resistant Staphylococcus aureus (MRSA) infections have recently become a major concern in long-term care facilities (LTCF). Patients that have been colonized with MRSA in general hospitals may introduce the organisms into LTCF, and these can become reservoirs for the pathogen. Our objective was to evaluate the rate of colonization by S aureus, especially MRSA, in elderly residents of a large LTCF, and to find factors that predispose to it.


METHODS
A nasal culture was obtained from randomly selected patients in an Israeli LTCF. Inclusion criteria were absence of active infection and no antibiotic treatment in the preceding month. The carrier state was defined when two consecutive cultures were positive for S aureus.


RESULTS
The study population comprised 270 patients, aged 81 +/- 9.3 years and from all types of wards. Of these, 63 (23.3%) were carriers of S aureus and 17 of those (27%) had MRSA. From univariate analysis, the carrier state was associated with antibiotic treatment or an invasive procedure in the previous 3 months, and with a prior MRSA infection. Subacute LTCF departments had a higher carrier rate than the chronic care wards.


CONCLUSIONS
In this large multilevel facility, 6.2% of the patients were MRSA carriers, and came predominantly from the subacute departments, suggesting an influx from general hospitals. This information and the identification of factors associated with MRSA infection permit the development of an institutional infection control program.
Mendelson
Gad
G
Shoham Geriatric Center, Pardes Hanna, Israel. gcmendelson@matat.health.gov.il
Yearmack
Yelena
Y
Granot
Ester
E
Ben-Israel
Joshua
J
Colodner
Raul
R
Raz
Raul
R
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D016022:Case-Control Studies; D015984:Causality; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D015994:Incidence; D017053:Infection Control; D007557:Israel / Q000453:epidemiology; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D009666:Nose / Q000382:microbiology; D015995:Prevalence; D012866:Skilled Nursing Facilities; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D013211:Staphylococcus aureus
D000900:Anti-Bacterial Agents