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Comparison of the Methicillin-Resistant Staphylococcus aureus Acquisition among Rehabilitation and Nursing Home Residents
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Mar 2011
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Source: Infect Control Hosp Epidemiol. 2011; 32(3):244-249
Details:
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Alternative Title:Infect Control Hosp Epidemiol
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Description:OBJECTIVE
To assess risk factors for methicillin-resistant Staphylococcus aureus (MRSA) acquisition among extended care residents focusing on level of care (residential vs rehabilitation) and room placement with an MRSA-positive resident.
DESIGN
Prospective cohort study.
SETTING
Extended care units at 2 healthcare systems in Maryland.
PARTICIPANTS
Four hundred forty-three residents with no history of MRSA and negative MRSA surveillance cultures of the anterior nares and areas of skin breakdown at enrollment.
METHODS
Follow-up cultures were collected every 4 weeks and/or at discharge for a period of 12 weeks. Study data were collected by a research nurse from the medical staff and the electronic medical records. Cox proportional hazards modeling was used to calculate adjusted hazards ratios (aHRs) and 95% confidence intervals (CIs).
RESULTS
. Residents in rehabilitation care had 4-fold higher risk of MRSA acquisition compared with residents in residential care (hazard ratio [HR], 4. [95% CI, 2.2–8.8]). Being bedbound was significantly associated with MRSA acquisition in both populations (residential care, aHR, 4.3 [95% CI, 1.5–12.2]; rehabilitation care, aHR, 4.8 [95% CI, 1.2–18.7]). Having an MRSA-positive roommate was not significantly associated with acquisition in either population (residential care, aHR, 1.4 [95% CI, 0.5–3.9]; rehabilitation care, aHR, 0.5 [95% CI, 0.1–2.2]); based on concordant spa typing, only 2 of 8 residents who acquired MRSA and had room placement with an MRSA-positive resident acquired their MRSA isolate from their roommate.
CONCLUSION
Residents in rehabilitation care appear at higher risk and have different risk factors for MRSA acquisition compared to those in residential care.
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Source:
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Pubmed ID:21460509
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Pubmed Central ID:PMC3677603
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