Comparison of the Methicillin-Resistant Staphylococcus aureus Acquisition among Rehabilitation and Nursing Home Residents
Published Date:Mar 2011
Source:Infect Control Hosp Epidemiol. 2011; 32(3):244-249.
Pubmed Central ID:PMC3677603
Funding:1K01AI071015-02/AI/NIAID NIH HHS/United States
1K12RR023250-05/RR/NCRR NIH HHS/United States
K01 AI071015/AI/NIAID NIH HHS/United States
K12 RR023250/RR/NCRR NIH HHS/United States
M01RR16500/RR/NCRR NIH HHS/United States
R01CI000369/CI/NCPDCID CDC HHS/United States
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.
Prospective cohort study.
Extended care units at 2 healthcare systems in Maryland.
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.
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).
. 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.
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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