Brief reportFactors for persistence of MRSA carriage one year after initial detection in individuals from various healthcare institutionsFactores de persistencia de la colonización por SARM un año más tarde de la detección inicial de portadores en distintos centros sanitarios
Introduction
Methicillin resistant Staphylococcus aureus (MRSA) colonization is prevalent in long-term healthcare facilities (LTHF), where many aged individuals with known risk factors and high antibiotic exposure reside.1 Moreover, transmission may be facilitated by close physical contact among residents and staff.2 Since LTHF residents are likely to require frequent admissions to acute care hospitals, epidemiology of MRSA infection in the latter may be influenced by its prevalence in LTHFs in their catchment areas.3 MRSA infection worsens the prognosis of hospitalized patients,4 but the significance of MRSA colonization has been less extensively evaluated. LTHF residents may be especially suited for epidemiological studies on the potential consequences of MRSA colonization and its long-term prognosis.2
Section snippets
Methods
During a month, patients admitted to the Hospital de Mataró (acute care reference hospital [ACH]) and residents in 4 of the LTHFs in its catchment area were tested for MRSA carriage. The ACH has 342 beds and the LTHFs a total of 421. They operate in an area with 220,000 inhabitants.
Nasal and ulcer swabs were performed in all adults admitted to/residing in any of the participating institutions. Each sample was given an encrypted identification code and processed in the Microbiological
Results
Among the 699 included individuals, 114 MRSA carriers were identified, 93 in LTHFs and 21 in the ACH, resulting in prevalence of 22.5% and 7.3%, respectively (p < 0.001). Carriers were aged 76.1 ± 11.9 years, and 55.3% were female. MRSA was isolated only from the nasal fossae in 61.4% of carriers, only from skin lesions in 21.1% and from both locations in 17.5%. 30% of MRSA carriers met criteria for infection.
Follow-up was complete for 56.6% of MRSA carriers. Fifty participants were lost to
Discussion
MRSA persistence was detected in 59.4% of the 64 colonized residents who completed the year of follow-up. Most of the factors independently associated to PC at F12 in our study were not easily modifiable: antibiotic exposure in the previous 6 months, having PU and more than 2 morbidities at baseline, and having PU or a poor functional status at the end of follow-up.
Previous works have established that a majority of MRSA colonized LTHF residents continue to be carriers after 1 year.6, 7 We found
Data protection
The authors claim that consent has been received for each patient enrolled, and that in this article patients’ personal data do not appear.
Conflict of interest
There is no conflict of interest in this study, including financial, personal or any other potential conflict.
References (10)
- et al.
Antibiotic use and microbiome function
Biochem Pharmacol
(2017) - et al.
Clinical significance of methicillin-resistant Staphylococcus aureus colonization in residents in community long-term-care facilities in Spain
Epidemiol Infect
(2012) - et al.
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
Rev Esp Quimioter
(2014) - et al.
Hospitalizations with healthcare-associated complicated skin and skin structure infections: impact of inappropriate empiric therapy on outcomes
J Hosp Med
(2010) - et al.
Quality control for commercially prepared microbiological culture media; approved standard—third edition. NCCLS document M22-A3
(2004)