Characteristics that promote transmission of Staphylococcus aureus nursing homes in German nursing homes.
OBJECTIVE
To determine factors that influence transmission of Staphylococcus aureus in nursing homes in the Rhine-Neckar region of southern Germany.


METHODS
Ecologic study.


METHODS
Forty-seven nursing homes in the region.


METHODS
Residents of the approached nursing homes who agreed to participate.


METHODS
Personal data and swabs of the nares were collected from participants. Swabs were examined for growth of S. aureus. All S. aureus isolates were typed using pulsed-field gel electrophoresis (PFGE). Transmission rates were calculated by dividing the number of transmissions (ie, cases in which two inhabitants shared the same PFGE type) by the number of S. aureus carriers. Characteristics of the nursing homes were correlated with a home's transmission rate.


RESULTS
In each nursing home, 12% to 54% of the residents were colonized with S. aureus. The transmission rates for the 47 nursing homes ranged from 0% to 70%. A linear regression model revealed that a stay in the nursing home of longer than 6 months and accommodation in a room with 3 or more beds were positively associated with the transmission rate. Receipt of antibiotics during the 4 weeks preceding the study was negatively associated with transmission.


CONCLUSIONS
Stays beyond 6 months and accommodation in rooms with multiple beds are important for the transmission of S. aureus. One way to reduce transmission would be to design facilities with single and double rooms. However, the social needs of the residents must be evaluated and respected.
Wendt
C
C
Hygiene-Institut, University of Heidelberg, Heidelberg, Germany. constanze_wendt@med.uni-heidelberg.de
Svoboda
D
D
Schmidt
C
C
Bock-Hensley
O
O
von Baum
H
H
D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D017053:Infection Control; D007902:Length of Stay; D016014:Linear Models; D008297:Male; D009735:Nursing Homes; D010362:Patients' Rooms; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D013211:Staphylococcus aureus / Q000302:isolation & purification