title: MRSA Prevalence and Risk Factors among Health Personnel and Residents in Nursing Homes in Hamburg, Germany - A Cross-Sectional Study.
abstract: BACKGROUND
  The increase of multidrug-resistant organisms in hospitals causes problems in nursing homes. Staff in geriatric nursing homes are at greater risk of MRSA colonisation. The aim of the study was to describe the occupational exposure to MRSA among health personnel in geriatric nursing.
  
  
  METHODS
  A point prevalence survey was conducted among health personnel and residents of geriatric nursing homes within the greater Hamburg district. Nasal swabs and, where relevant, wound swabs were collected for the screening survey. Risk factors for MRSA colonisation were identified by means of a questionnaire and using the files held on the residents. Where tests on nursing staff were positive, a control swab was taken; when the results were confirmed positive, decolonisation was performed. The responsible general practitioners were notified of positive MRSA findings among residents. A molecular biological examination of the MRSA samples was performed.
  
  
  RESULTS
  A total of 19 institutions participated in the study. Nasal swabs were taken from 759 nursing staff and 422 residents. Prevalence of MRSA was 1.6% among staff and 5.5% among residents. MRSA colonisation among health personnel indicated a correlation with male gender (OR 4.5, 95% CI 1.4-14.1). Among the residents, chronic skin diseases (OR 3.2, 95% CI 1.0-10.3) and indwelling devices (OR 3.2, 95% CI 1.2-8.1) were identified as risk factors. No link between MRSA in residents and in health personnel could be established.
  
  
  CONCLUSIONS
  The number of MRSA colonisations among nursing staff and residents of geriatric nursing homes in Hamburg was rather low at 1.6% and 5.5% respectively and equates to the results of other surveys in non-outbreak scenarios.
authors.affiliation: Institute for Health Services Research in Dermatology and Nursing, CVcare, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Peters
authors.affiliation: Department of Occupational Health Research, Institution for Statutory Accident Insurance and Prevention in Healthcare and Welfare, Hamburg, Germany.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Dulon
authors.affiliation: Institute for Health Services Research in Dermatology and Nursing, CVcare, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Olaf
authors.initials: O
authors.lastname: Kleinmüller
authors.affiliation: Institute for Health Services Research in Dermatology and Nursing, CVcare, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.|Department of Occupational Health Research, Institution for Statutory Accident Insurance and Prevention in Healthcare and Welfare, Hamburg, Germany.
authors.forename: Albert
authors.initials: A
authors.lastname: Nienhaus
authors.affiliation: Institute for Health Services Research in Dermatology and Nursing, CVcare, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Schablon
mesh_terms: D002353:Carrier State / Q000453:epidemiology*; D003428:Cross Infection / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006282:Health Personnel; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics; D009735:Nursing Homes; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*