Profile of methicillin-resistant Staphylococcus aureus among nursing home residents in Hawai'i.
Residing in long-term care facilities has long been identified as a risk factor for methicillin-resistant Staphylococcus aureus (MRSA) carriage and infection. The objective of this study was to describe MRSA epidemiology among residents in skilled nursing and intermediate care facilities (SNF/ICF) in Hawai'i, using a statewide, population-based antimicrobial resistance surveillance system. From 2000 to 2005, proportions of MRSA increased significantly during the 6-year study period, from 35.0% in 2000 to 58.6% in 2005 (p < 0.001). High levels of MRSA resistance to several commonly used antibiotics were observed, e.g., the level of MRSA resistance to clindamycin, ciprofloxacin, and erythromycin was at 77%, 90%, and 89% respectively. Nevertheless, there is a significant difference in the MRSA resistance pattern against certain antimicrobials in different geographic areas. For example, the level of MRSA resistance to trimethoprim-sulfamethoxazole was close to zero in Hawai'i County, but 13% in Kaua'i County. In contrast, the MRSA resistance to tetracycline was 46% in Hawai'i County, but 5% in Kaua'i County. Multi-drug resistant MRSA was well-established among nursing homes in Hawai'i. Regional antibiograms are important in the assistance of empirical therapy.
Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI 96822, USA. fenfang@hawaii.edu
Fenfang
F
Li
Pamela
P
Arnsberger
F DeWolfe
FD
Miller
D000368:Aged; D000369:Aged, 80 and over; D004352:Drug Resistance, Microbial; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D008826:Microbial Sensitivity Tests; D009735:Nursing Homes; D011159:Population Surveillance; D013203:Staphylococcal Infections / Q000453:epidemiology*