Screening for methicillin-resistant Staphylococcus aureus (MRSA) carriage on admission to a geriatric hospital.
Our objective is to identify risk factors for carriage of MRSA on admission to a geriatric hospital where MRSA is endemic. A prospective screening for MRSA carriage was conducted by swabbing anterior nares and anal skin for 6 weeks. One hundred and thirty-eight patients aged over 65 were enrolled after obtaining their informed consent. Swabs of anterior nares and anal skin of patients were submitted for culture for MRSA. The demographic, administrative, and clinical data for each participant were recorded, and their association with MRSA carriage was determined by stepwise regression analysis. MRSA was recovered from 11 patients (11/138 patients, 8.0%), and from anal skin in 8 of them. Without screening of anal skin, 5 out of 11 carriers had been missed. Multivariate analysis revealed that hypoalbuminemia (adjusted risk ratio, RR=6.39, 95% confidence interval, CI=1.08-37.84) and bedridden status (RR=8.26, CI=1.04-65.31) were independent risk factors. Screening of elderly patients for gastrointestinal colonization on admission had implications for early detection of the reservoir of MRSA. Systematic selective screening for MRSA carriage targeting high-risk patients with hypoalbuminemia or bedridden status would be useful for infection control of this resistant organism.
Nishikawa
Mitsunori
M
Department of Respiratory Medicine, National Center for Geriatrics and Gerontology Hospital, 36-3 Gengo, Morioka, Obu, Aichi 474-8511, Japan.
Tanaka
Tomoko
T
Department of Respiratory Medicine, National Center for Geriatrics and Gerontology Hospital, 36-3 Gengo, Morioka, Obu, Aichi 474-8511, Japan.
Nakashima
Kazumitsu
K
Department of Respiratory Medicine, National Center for Geriatrics and Gerontology Hospital, 36-3 Gengo, Morioka, Obu, Aichi 474-8511, Japan.
Senda
Kazuyoshi
K
Department of Respiratory Medicine, National Center for Geriatrics and Gerontology Hospital, 36-3 Gengo, Morioka, Obu, Aichi 474-8511, Japan.
Shibasaki
Masataka
M
Department of Respiratory Medicine, National Center for Geriatrics and Gerontology Hospital, 36-3 Gengo, Morioka, Obu, Aichi 474-8511, Japan.
Miura
Hisayuki
H
Department of Geriatric Medicine, National Center for Geriatrics and Gerontology Hospital, 36-3 Gengo, Morioka, Obu, Aichi 474-8511, Japan.
Tamakoshi
Akiko
A
Department of Public Health, Aichi Medical University School of Medicine, 21 Karimata, Yazako, Nagakute-cho, Aichi-gun 480-1195, Japan.
Ohta
Toshiki
T
Department of Geriatric Medicine, National Center for Geriatrics and Gerontology Hospital, 36-3 Gengo, Morioka, Obu, Aichi 474-8511, Japan.
Yagi
Tetsuya
T
Department of Respiratory Medicine, National Center for Geriatrics and Gerontology Hospital, 36-3 Gengo, Morioka, Obu, Aichi 474-8511, Japan. Electronic address: tyagi@ncgg.go.jp.
D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000382:microbiology; D002353:Carrier State / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D003955:Diagnostic Tests, Routine; D005260:Female; D005853:Geriatrics; D006782:Hospitals, Special; D006801:Humans; D034141:Hypoalbuminemia; D007103:Immobilization; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D009296:Nasal Cavity / Q000382:microbiology; D011159:Population Surveillance; D012307:Risk Factors