title: Natural history of meticillin-resistant Staphylococcus aureus colonisation among residents in community long term care facilities in Spain.
abstract: The spread of meticillin-resistant Staphylococcus aureus (MRSA) is a major problem for both acute care hospitals and among residents in long term care facilities (LTCFs). We performed a cohort study to assess the natural history of MRSA colonisation in LTCF residents. Two cohorts of residents (231 MRSA carriers and 196 non-carriers) were followed up for an 18 month period, with cultures of nasal and decubitus ulcers performed every six months. In the MRSA carrier cohort, 110 (47.8%) residents had persistent MRSA colonisation for six months or longer, 44 (19.0%) had transient colonisation and nine (3.9%) were intermittently colonised. No risk factors for persistent MRSA colonisation could be determined. The annual incidence of MRSA acquisition was around 20% [95% confidence interval (CI): 14.3-25.5]. Antibiotic treatment was independently associated with MRSA acquisition (odds ratio: 2.27; 95% CI: 1.05-4.88; P=0.03). Just two clones were distinguishable by pulsed-field gel electrophoresis and multilocus sequence typing: CC5-MRSA IV, which is widely disseminated in Spanish hospitals, and ST22-MRSA IV. This study adds to the knowledge of the epidemiology of MRSA in community LTCFs, which are important components of long term care in Spain.
authors.affiliation: Infectious Diseases Service, Hospital Universitari de Bellvitge, Barcelona, Spain. admanzur@yahoo.com.ar
authors.forename: A
authors.initials: A
authors.lastname: Manzur
authors.forename: M A
authors.initials: MA
authors.lastname: Dominguez
authors.forename: E
authors.initials: E
authors.lastname: Ruiz de Gopegui
authors.forename: D
authors.initials: D
authors.lastname: Mariscal
authors.forename: L
authors.initials: L
authors.lastname: Gavalda
authors.forename: F
authors.initials: F
authors.lastname: Segura
authors.forename: J L
authors.initials: JL
authors.lastname: Perez
authors.forename: M
authors.initials: M
authors.lastname: Pujol
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008134:Long-Term Care; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics / Q000302:isolation & purification*; D017720:Molecular Epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology