Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-18T00:39:11.042Z Has data issue: false hasContentIssue false
  • English
  • Français

Prevalence of Methicillin-Resistant Staphylococcus aureus Colonization Among Older Residents of Care Homes in the United Kingdom

Published online by Cambridge University Press:  02 January 2015

Benjamin Barr ,
Mark H. Wilcox ,
Angela Brady ,
Peter Parnell ,
Bob Darby  and
David Tompkins
Benjamin Barr*
Affiliation:
West Lancashire PCT, Ormskirk and District General Hospital, Lancashire, Leeds, United Kingdom
Mark H. Wilcox
Affiliation:
Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
Angela Brady
Affiliation:
Leeds North East PCT, Leeds, United Kingdom
Peter Parnell
Affiliation:
Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
Bob Darby
Affiliation:
Leeds North East PCT, Leeds, United Kingdom
David Tompkins
Affiliation:
Health Protection Agency, Yorkshire and the Humber, Leeds, United Kingdom
*
West Lancashire PCT, Ormskirk and District General Hospital, Wigan Road, Ormskirk, Lancashire L39 2IW, United Kingdom (ben@benbarr.wanadoo.co.uk)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective.

To determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization among older residents of care homes in Leeds, United Kingdom, and to identify resident and care home risk factors for carriage.

Design.

We conducted a cross-sectional prevalence survey of 715 residents from 39 care homes. All participants were tested for nasal colonization with S. aureus, including MRSA. A short questionnaire was completed about each participant and each care home. A multivariable model was used to determine which risk factors were independently associated with MRSA colonization.

Setting.

Care homes for older residents in Leeds, United Kingdom.

Participants.

All residents in participating homes who were able to give informed consent.

Results.

A total of 159 of 715 residents tested positive for MRSA, for a prevalence of 22% (95% confidence interval, 18%—27%) The resultant multivariate model showed that residence in a home with a low ratio of nurses to beds, residence in a care home in a deprived area, male sex, presence of an invasive device, and a hospitalization duration of more than 10 days during the previous 2 years were independently associated with MRSA colonization.

Conclusions.

This study found a large reservoir of MRSA within the care home population. Control strategies need to be coordinated between care homes and hospitals. Increasing the ratio of nurses to beds, reducing the duration of hospitalization, and improving the management of invasive devices could help reduce the prevalence of MRSA colonization. Further research is required to ascertain the potential health benefits of reducing the rate of MRSA colonization among care home residents.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 7 , July 2007 , pp. 853 - 859
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Roberts, C, Mayon, , White, R, Casey, G. Audit of Infection Control Practice in Nursing Homes. London, England: Public Health Laboratory Service; 2000.Google Scholar
2.Wyllie, D, Peto, T, Crook, D. MRSA bacteraemia in patients on arrival in hospital: a cohort study in Oxfordshire 1997-2003. BMJ 2005;331:992–998.Google Scholar
3.Fraise, P, Mitchell, K, O'Brien, S, Oldfield, K, Wise, R. Methicillin-resistant Staphylococcus aureus (MRSA) in nursing homes in a major UK city: an anonymized point prevalence survey. Epidemiol Infect 1997;118:1–5.CrossRefGoogle Scholar
4.Namnyak, S, Adhami, Z, Wilmore, M, et al.Methicillin-resistant Staphylococcus aureus: a questionnaire and microbiological survey of nursing and residential homes in Barking, Havering and Brentwood. J Infect 1998;36:67–72.Google Scholar
5.Cox, R, Bowie, P. Methicillin-resistant Staphylococcus aureus colonisation in nursing home residents: a prevalence study in Northamptonshire. J Hosp Infect. 1999;43:115–122.CrossRefGoogle ScholarPubMed
6.Care Standards Act 2000. London, England: Stationery Office; 2006.Google Scholar
7.Access [computer program]. Redmond, WA: Microsoft; 2002.Google Scholar
8.Office of the Deputy Prime Minister. The English Indices of Deprivation 2004. London, England: Stationery Office; 2004.Google Scholar
9.StataCorp. Intercooled Stata for Windows. College Station, TX: StataCorp; 2001.Google Scholar
10.Rabe-Hesketh, S, Skrondal, A, Pickles, A. GLAMM Manual. UC Berkeley Division of Biostatistics Working Paper Series. Berkley: University of California; 2004;160:1–138.Google Scholar
11.von Baum, H, Schmidt, C, Svoboda, D, Bock-Hensley, O, Wendt, C. Risk factors for methicillin-resistant Staphylococcus aureus carriage in residents of German nursing homes. Infect Control Hosp Epidemiol 2002;23:511–515.Google Scholar
12.Madhavi, B. Health Survey for England. London, England: The Stationery Office; 2000.Google Scholar
13.Meurman, O, Routamaa, M, Peltonen, R. Screening for methicillin-resistant Staphylococcus aureus: which anatomical sites to culture. J Hosp Infect 2005;61:351–353.Google Scholar
14.Godwin, P, Choyce, A, McCarthy, S. The prevalence of MRSA carriage measured over five years in a District General Hospital [comment]. J Hosp Infect 2001;47:73–75.CrossRefGoogle Scholar
15.Hori, S, Sunley, R, Tami, A, Grundmann, H. The Nottingham Staphylococcus aureus population study: prevalence of MRSA among the elderly in a university hospital. J Hosp Infect 2002;50:25–29.Google Scholar
16.Eveillard, M, Ernst, C, Cuviller, S, et al.Prevalence of methicillin-resistant Staphylococcus aureus carriage at the time of admission in two acute geriatric wards. J Hosp Infect 2002;50:122–126.Google Scholar
17.Lucet, JC, Grenet, K, Armand-Lefevre, L, et al.High prevalence of carriage of methicillin-resistant Staphylococcus aureus at hospital admission in elderly patients: implications for infection control strategies. Infect Control Hosp Epidemiol 2005;26:121–126.Google Scholar
18.Hirsch, D. Facing the Cost of Long Term Care. York, England: Joseph Rowntree Foundation; 2005.Google Scholar
19.Muto, C, Jernigan, JA, Ostrowsky, BE. SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and enterococcus. Society for Healthcare Epidemiology of America. Infect Control Hosp Epidemiol 2003;24:362–386.CrossRefGoogle Scholar
20.Coia, JE, Duckworth, GJ, Edwards, DI, et al.Guidelines for the control and prevention of methicillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities: for the Joint Working Party of the British Society of Antimicrobial Chemotherapy, the Hospital Infection Society, and the Infection Control Nurses Association. J Hosp Infect 2006;63(suppl 1): S1–S44.Google Scholar
21.Clinical and cost effectiveness of screening for MRSA. Available at: http://www.nhshealthquality.org/nhsqis/2498.html. Accessed March 4, 2006.Google Scholar
22.Jernigan, JA, Pullen, AL, Flowers, L, Bell, M, Jarvis, WR. Prevalence of and risk factors for colonization with methicillin-resistant Staphylococcus aureus at the time of hospital admission. Infect Control Hosp Epidemiol 2003;24:409–414.Google Scholar
23.Heudorf, U, Bremer, V, Heuck, D. Methicillin-resistant Staphylococcus aureus in long-term care facilities for the aged in Frankfurt am Main, Germany, in 1999 [in German]. Gesundheitswesen 2001;63:447–454.CrossRefGoogle Scholar
24.McNulty, C, Freeman, E, Smith, G, et al.Prevalence of urinary catheterization in UK nursing homes. J Hosp Infect 2003;55:119–123.Google Scholar
25.Abudu, L, Blair, I, Fraise, A, Cheng, K. Methicillin-resistant Staphylococcus aureus (MRSA): a community-based prevalence survey. Epidemiol Infect 2001;126:351–356.Google Scholar
26.O'Sullivan, R, Keane, T. The prevalence of methicillin-resistant Staphylococcus aureus among the residents of six nursing homes for the elderly. J Hosp Infect 2000;45:322–329.Google Scholar
27.Price, MF, McBride, ME, Wolf, JE Jr.Prevalence of methicillin-resistant Staphylococcus aureus in a dermatology outpatient population. Southern Med J 1998;91:369–371.Google Scholar
28.Louria, D. Emerging and re-emerging infections: the societal determinants. Futures 2000;32:581–594.Google Scholar
29.Grundmann, H, Tami, A, Hori, S, Halwani, M, Slack, R. Nottingham Staphylococcus aureus population study: prevalence of MRSA among elderly people in the community. BMJ 2002;324:1365–1366.CrossRefGoogle ScholarPubMed
30.Bagger, J, Zindrou, D, Taylor, K. Postoperative infection with methicillin-resistant Staphylococcus aureus and socioeconomic Background. Lancet 2004;363:706–708.CrossRefGoogle ScholarPubMed