[Predictive factors of acquired methicillin-resistant Staphylococcus aureus in a rehabilitation care unit].
Controlling the diffusion of multiresistant bacteria is a priority in the campaign against nosocomial infections. Geriatric units seem to be reservoirs of methicillin-resistant Staphylococcus aureus (MRSA).


OBJECTIVE
The first objective of this study was to determine if some characteristics identified on admission in a rehabilitation care unit could influence the colonization by the bacterium, and to define the rate of importation and acquired-infections. The second objective was to evaluate the preventive effects of enhanced cleaning with hydro-alcoholic solution, in comparison with our previous study made five years before.


METHODS
One hundred and eighty-eight patients (mean age, 83.75 ± 7.35 years) were included.


RESULTS
The rates of importation and colonization were respectively of 22.4% and 25.5%. The predictive factors of acquisition were dependence, malnutrition, presence of urinary catheter, and chronic wounds. The comparison with data collected five years earlier showed a reduction of colonization rates from 44 to 25%.


CONCLUSIONS
Our study highlights the important role of hand contamination in colonization of the MRSA especially for dependent patients, and shows the importance of hand-hygiene compliance, as well as maintaining autonomy among old patients. The use of hydro-alcoholic solution in association with the reinforcement of hospital hygiene measures led to the decrease of acquired-infection rate.
Service du Dr Vincent, Hôpital Emile-Roux, 1 Avenue de Verdun, 94450 Limeil Brevannes, France.
A
A
Anguelov
K
K
Giraud
A
A
Akpabie
G
G
Chatap
J-P
JP
Vincent
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D000431:Ethanol; D005260:Female; D005602:France; D019983:Guideline Adherence; D006235:Hand Disinfection; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006765:Hospitals, Convalescent / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D014546:Urinary Catheterization / Q000706:statistics & numerical data; D014867:Water; D014947:Wounds and Injuries / Q000453:epidemiology
D000891:Anti-Infective Agents, Local; D014867:Water; D000431:Ethanol