title: Prevalence and risk factors for meticillin-resistant Staphylococcus aureus in an acute care hospital and long-term care facilities located in the same geographic area.
abstract: To determine the prevalence and risk factors (RF) for methicillin-resistant Staphylococcus aureus (MRSA) during stay in 1 acute care hospital (ACH) and 4 long-term care facilities (LTCF). After obtaining the informed consent, nasal and skin ulcer swabs were taken and a survey was conducted to determine RF for MRSA. Six hundred and ninety nine patients were included, 413 LTCF and 286 ACH patients and MRSA prevalence were 22.5% and 7.3% respectively. MRSA was located in the nares, skin ulcers, and in both in 61.4%, 21.1%, and 17.5%. Among MRSA carriers, 81% of the ACH and 66.7% of the LTCF patients were only colonized. The multivariate analysis for the ACH revealed the following factors to be associated with MRSA: referral from an LTCF (OR 4.84), pressure ulcers (OR 4.32), a Barthel score < 60 (OR 2.60), and being male (OR 5.21). For the LTCF: urinary catheterisation (OR 3.53), pressure ulcers (OR 2.44), other skin lesions (OR 2.64), antibiotic treatment in ≤ 6 months, (OR 2.23), previous MRSA colonization (OR 2.15), and a Barthel score <20 (OR 1.28). Molecular typing identified 2 predominant clones Q, P, present in all centres. No relationship was found between clones and antibiotic susceptibility.
  
  
  CONCLUSIONS
  MRSA prevalence is high in all centres but is 3 times greater in LTCF. The risk factors most strongly associated with MRSA were pressure ulcers and a stay in an LTCF. We propose preventive isolation in these cases.
authors.affiliation: M. Pilar Barrufet, Internal Medicine Unit. Hospital de Mataró, C/ Cirera sn. Mataró, 08304. Barcelona, Spain. mbarrufet@csdm.cat.
authors.forename: M P
authors.initials: MP
authors.lastname: Barrufet
authors.forename: E
authors.initials: E
authors.lastname: Vendrell
authors.forename: L
authors.initials: L
authors.lastname: Force
authors.forename: G
authors.initials: G
authors.lastname: Sauca
authors.forename: S
authors.initials: S
authors.lastname: Rodríguez
authors.forename: E
authors.initials: E
authors.lastname: Martínez
authors.forename: E
authors.initials: E
authors.lastname: Palomera
authors.forename: M
authors.initials: M
authors.lastname: Serra-Prat
authors.forename: J A
authors.initials: JA
authors.lastname: Capdevila
authors.forename: J
authors.initials: J
authors.lastname: Cornudella
authors.forename: A
authors.initials: A
authors.lastname: Llopis
authors.forename: M A
authors.initials: MA
authors.lastname: Robledo
authors.forename: C
authors.initials: C
authors.lastname: Vázquez
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006761:Hospitals; D006801:Humans; D008134:Long-Term Care; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012871:Skin Diseases / Q000150:complications / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult