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.
Li
Fenfang
F
Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI 96822, USA. fenfang@hawaii.edu
Arnsberger
Pamela
P
Miller
F DeWolfe
FD
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*