Prevalence of methicillin-resistant Staphylococcus aureus colonization among older residents of care homes in the United Kingdom.
OBJECTIVE
To determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization among older residents of care homes in Leeds, United Kingdom, and to identify resident and care home risk factors for carriage.


METHODS
We conducted a cross-sectional prevalence survey of 715 residents from 39 care homes. All participants were tested for nasal colonization with S. aureus, including MRSA. A short questionnaire was completed about each participant and each care home. A multivariable model was used to determine which risk factors were independently associated with MRSA colonization.


METHODS
Care homes for older residents in Leeds, United Kingdom.


METHODS
All residents in participating homes who were able to give informed consent.


RESULTS
A total of 159 of 715 residents tested positive for MRSA, for a prevalence of 22% (95% confidence interval, 18%-27%) The resultant multivariate model showed that residence in a home with a low ratio of nurses to beds, residence in a care home in a deprived area, male sex, presence of an invasive device, and a hospitalization duration of more than 10 days during the previous 2 years were independently associated with MRSA colonization.


CONCLUSIONS
This study found a large reservoir of MRSA within the care home population. Control strategies need to be coordinated between care homes and hospitals. Increasing the ratio of nurses to beds, reducing the duration of hospitalization, and improving the management of invasive devices could help reduce the prevalence of MRSA colonization. Further research is required to ascertain the potential health benefits of reducing the rate of MRSA colonization among care home residents.
Barr
Benjamin
B
West Lancashire PCT, Ormskirk and District General Hospital, Ormskirk, Lancashire, L39 2JW, UK. ben@benbarr.wanadoo.co.uk
Wilcox
Mark H
MH
Brady
Angela
A
Parnell
Peter
P
Darby
Bob
B
Tompkins
David
D
D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology* / Q000517:prevention & control / Q000635:transmission; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D017053:Infection Control / Q000379:methods; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012866:Skilled Nursing Facilities / Q000458:organization & administration / Q000639:trends; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000635:transmission; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D006113:United Kingdom / Q000453:epidemiology