title: Carriage of methicillin-resistant Staphylococcus aureus on admission to European rehabilitation centres--a prospective study.
abstract: This study aimed to determine the prevalence of and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) carriage among patients newly admitted to rehabilitation centres. It is a prospective study examining MRSA carriage on admission to seven rehabilitation wards in four countries. Risk factors for MRSA carriage were analysed using univariate and multivariate analyses. A total of 1204 patients were studied. Among them, 105 (8.7%) had a positive admission MRSA screening result. The MRSA carriers were more likely to be male, to have had a recent stay in another long-term-care facility or >2 weeks acute-care hospital stay, history of colonization with MRSA, reduced level of consciousness, peripheral vascular disease and pressure sores. In multivariable logistic regression male gender (odds ratio (OR) 2.2, 95% confidence interval (CI) 1.4-3.6, p 0.001), history of MRSA positivity (OR 6.8, 95% CI 3.8-12.3, p <0.001), peripheral vascular disease (OR 2.5, 95% CI 1.2-5, p 0.013), recent stay in another long-term-care facility (OR 2.1, 95% CI 1.3-3.5, p 0.004), or long (>2 weeks) acute-care hospital stay (OR 1.9, 95% CI 1.2-3, p 0.004), remained significant risk factors for MRSA carriage. MRSA carriage is common on admission to rehabilitation centres but less so, than previously described in long-term-care facilities. Male gender, history of MRSA positivity, previous hospitalization and peripheral vascular disease may predict MRSA carriage, and may serve as indicators for using pre-emptive infection control measures.
authors.affiliation: Division of Epidemiology and Preventive Medicine, Tel-Aviv Sourasky Medical Centre, Tel Aviv University, Tel Aviv, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Bilavsky
authors.forename: Y
authors.initials: Y
authors.lastname: Lerman
authors.forename: A
authors.initials: A
authors.lastname: Rabinovich
authors.forename: J
authors.initials: J
authors.lastname: Salomon
authors.forename: C
authors.initials: C
authors.lastname: Lawrence
authors.forename: A
authors.initials: A
authors.lastname: Rossini
authors.forename: A
authors.initials: A
authors.lastname: Salvia
authors.forename: J V
authors.initials: JV
authors.lastname: Samso
authors.forename: J
authors.initials: J
authors.lastname: Fierro
authors.forename: M
authors.initials: M
authors.lastname: Hochman
authors.forename: M
authors.initials: M
authors.lastname: Kazma
authors.forename: A
authors.initials: A
authors.lastname: Klein
authors.forename: M J
authors.initials: MJ
authors.lastname: Schwaber
authors.forename: Y
authors.initials: Y
authors.lastname: Carmeli
mesh_terms: D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D005060:Europe / Q000453:epidemiology; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D015995:Prevalence; D011446:Prospective Studies; D012047:Rehabilitation Centers; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology