title: Risk factors for methicillin-resistant Staphylococcus aureus carriage among residents in 7 nursing homes in Shanghai, China.
abstract: Nursing home residents are a population at risk for methicillin-resistant Staphylococcus aureus (MRSA) carriage, but few data about MRSA in this setting in Shanghai are available. The aim of this study is to determine the prevalence and risk factors for MRSA carriage in nursing home residents in Shanghai, China.
  
  
  
  Four hundred forty-three residents from 7 nursing homes in Shanghai, China, participated in this study; nasal and axillary swabs were obtained from these residents. Laboratory identification for S aureus and antimicrobial susceptibility testing were performed when isolated. Data, including individual resident characteristics and nursing home characteristics, were collected and analyzed.
  
  
  
  Of the 443 participating residents, 99 (22.3%) and 45 (10.2%) residents were colonized by S aureus and MRSA, respectively. Previous hospitalization (odds ratio [OR], 2.564; 95% confidence interval [CI], 1.214-5.415; P = .014), presence of an invasive device (OR, 3.455; 95% CI, 1.678-7.113; P = .001), chloramphenicol therapy (OR, 7.672; 95% CI, 1.807-32.580; P = .006), and macrolides therapy (OR, 2.796; 95% CI, 1.056-7.403; P = .038) were independent risk factors for MRSA colonization. Low expenditure per month and less good sanitary condition also increased the risk for MRSA colonization.
  
  
  
  Our study suggests that nursing homes are significant reservoirs for MRSA. Implementation of infection control strategies must be given high priority in nursing homes to fight the high prevalence of MRSA, and increased convenience and feasibility should also be realized with these control strategies for MRSA colonization.
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Fei-Fei
authors.initials: FF
authors.lastname: Gu
authors.affiliation: Department of Clinical Laboratory, Shanghai People's Hospital of Putuo District, Shanghai, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Sheng-Yuan
authors.initials: SY
authors.lastname: Zhao
authors.affiliation: Center of Post-Marketing Safety Evaluation, Peking University Health Science Center, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
authors.forename: Zhi-Rong
authors.initials: ZR
authors.lastname: Yang
authors.affiliation: Division of Epidemiology, School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
authors.forename: Yue-Lun
authors.initials: YL
authors.lastname: Zhang
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Shu-Zhen
authors.initials: SZ
authors.lastname: Xiao
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Su
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Microbiology and Parasitology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Xiao-Kui
authors.initials: XK
authors.lastname: Guo
authors.affiliation: Department of Pulmonary Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jie-Ming
authors.initials: JM
authors.lastname: Qu
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yu-Xing
authors.initials: YX
authors.lastname: Ni
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: hanlizhong1107@163.com.
authors.forename: Li-Zhong
authors.initials: LZ
authors.lastname: Han
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000382:microbiology; D001431:Bacteriological Techniques; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D009297:Nasal Mucosa / Q000382:microbiology; D009735:Nursing Homes; D010865:Pilot Projects; D015995:Prevalence; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D011795:Surveys and Questionnaires
keywords: Chloramphenicol therapy; Colonization; Invasive device; Macrolides therapy; Previous hospitalization