Association between length of residence and prevalence of MRSA colonization among residents in geriatric long-term care facilities.
Geriatric long-term care facility
Infection control and prevention
Methicillin-resistant Staphylococcus aureus (MRSA)
Older adults
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
18 11 2020
18 11 2020
Historique:
received:
08
09
2020
accepted:
09
11
2020
entrez:
19
11
2020
pubmed:
20
11
2020
medline:
14
1
2021
Statut:
epublish
Résumé
A high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization has been reported among residents in geriatric long-term care facilities (LTCFs). Some studies indicate that MRSA might be imported from hospitals into LTCFs via resident transfer; however, other studies report that high MRSA prevalence might be caused by cross-transmission inside LTCFs. We aimed to assess which factors have a large impact on the high MRSA prevalence among residents of geriatric LTCFs. We conducted a cohort study among 260 residents of four geriatric LTCFs in Japan. Dividing participants into two cohorts, we separately analyzed (1) the association between prevalence of MRSA carriage and length of LTCF residence (Cohort 1: n = 204), and (2) proportion of residents identified as MRSA negative who were initially tested at admission but subsequently identified as positive in secondary testing performed at ≥2 months after their initial test (Cohort 2: n = 79). Among 204 residents in Cohort 1, 20 (9.8%) were identified as positive for MRSA. Compared with residents identified as MRSA negative, a larger proportion of MRSA-positive residents had shorter periods of residence from the initial admission (median length of residence: 5.5 vs. 2.8 months), although this difference was not statistically significant (p = 0.084). Among 79 residents in Cohort 2, 60 (75.9%) were identified as MRSA negative at the initial testing. Of these 60 residents, only one (1.7%) had subsequent positive conversion in secondary MRSA testing. In contrast, among 19 residents identified as MRSA positive in the initial testing, 10 (52.6%) were negative in secondary testing. The prevalence of MRSA was lower among residents with longer periods of LTCF residence than among those with shorter periods. Furthermore, few residents were found to become MRSA carrier after their initial admission. These findings highlight that MRSA in LTCFs might be associated with resident transfer rather than spread via cross-transmission inside LTCFs.
Sections du résumé
BACKGROUND
A high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization has been reported among residents in geriatric long-term care facilities (LTCFs). Some studies indicate that MRSA might be imported from hospitals into LTCFs via resident transfer; however, other studies report that high MRSA prevalence might be caused by cross-transmission inside LTCFs. We aimed to assess which factors have a large impact on the high MRSA prevalence among residents of geriatric LTCFs.
METHODS
We conducted a cohort study among 260 residents of four geriatric LTCFs in Japan. Dividing participants into two cohorts, we separately analyzed (1) the association between prevalence of MRSA carriage and length of LTCF residence (Cohort 1: n = 204), and (2) proportion of residents identified as MRSA negative who were initially tested at admission but subsequently identified as positive in secondary testing performed at ≥2 months after their initial test (Cohort 2: n = 79).
RESULTS
Among 204 residents in Cohort 1, 20 (9.8%) were identified as positive for MRSA. Compared with residents identified as MRSA negative, a larger proportion of MRSA-positive residents had shorter periods of residence from the initial admission (median length of residence: 5.5 vs. 2.8 months), although this difference was not statistically significant (p = 0.084). Among 79 residents in Cohort 2, 60 (75.9%) were identified as MRSA negative at the initial testing. Of these 60 residents, only one (1.7%) had subsequent positive conversion in secondary MRSA testing. In contrast, among 19 residents identified as MRSA positive in the initial testing, 10 (52.6%) were negative in secondary testing.
CONCLUSIONS
The prevalence of MRSA was lower among residents with longer periods of LTCF residence than among those with shorter periods. Furthermore, few residents were found to become MRSA carrier after their initial admission. These findings highlight that MRSA in LTCFs might be associated with resident transfer rather than spread via cross-transmission inside LTCFs.
Identifiants
pubmed: 33208107
doi: 10.1186/s12877-020-01885-1
pii: 10.1186/s12877-020-01885-1
pmc: PMC7672839
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
481Subventions
Organisme : Japan Agency for Medical Research and Development
ID : JP20dk0110030
Pays : International
Références
J Am Med Dir Assoc. 2020 Jan;21(1):1-4
pubmed: 31888861
Clin Infect Dis. 2003 Dec 1;37(11):1467-74
pubmed: 14614669
Antimicrob Resist Infect Control. 2018 Mar 6;7:33
pubmed: 29527303
BMC Infect Dis. 2019 Jan 9;19(1):35
pubmed: 30626342
J Clin Microbiol. 2013 Nov;51(11):3788-95
pubmed: 24025901
Epidemiol Infect. 2013 Jun;141(6):1199-206
pubmed: 22953727
J Hosp Infect. 2010 Nov;76(3):215-9
pubmed: 20692073
J Med Microbiol. 2013 Mar;62(Pt 3):437-440
pubmed: 23222858
J Am Med Dir Assoc. 2007 Mar;8(3 Suppl):S18-25
pubmed: 17336871
Infect Control Hosp Epidemiol. 2007 Jul;28(7):853-9
pubmed: 17564989
BMC Infect Dis. 2011 May 20;11:138
pubmed: 21599908
J Rural Med. 2019 May;14(1):73-77
pubmed: 31191769
J Gen Fam Med. 2018 Mar 09;19(3):77-81
pubmed: 29744260
Infection. 2009 Jun;37(3):216-21
pubmed: 19148574
PLoS One. 2019 Mar 28;14(3):e0214327
pubmed: 30921364
Infect Control Hosp Epidemiol. 2012 Jun;33(6):551-7
pubmed: 22561709
Curr Infect Dis Rep. 2017 Apr;19(4):18
pubmed: 28382547
Clin Microbiol Infect. 2009 Dec;15 Suppl 7:26-30
pubmed: 19951331
Am J Infect Control. 2019 Dec;47(12):1415-1419
pubmed: 31324491
Clin Microbiol Infect. 2008 Sep;14(9):867-72
pubmed: 18844688
Clin Infect Dis. 2011 Nov;53(9):910-3
pubmed: 21984272
J Am Geriatr Soc. 2018 Apr;66(4):789-803
pubmed: 29667186
Diagn Microbiol Infect Dis. 2012 Mar;72(3):253-7
pubmed: 22244779
Microb Drug Resist. 2019 Jul/Aug;25(6):915-924
pubmed: 30897025
J Infect Chemother. 2009 Aug;15(4):262-5
pubmed: 19688248
J Hosp Infect. 2006 Nov;64(3):251-6
pubmed: 16978733
J Am Geriatr Soc. 2018 Jul;66(7):1284-1289
pubmed: 29664994
J Am Geriatr Soc. 2017 Mar;65(3):631-641
pubmed: 28140454
Ann Clin Microbiol Antimicrob. 2018 May 4;17(1):18
pubmed: 29728115
Am J Infect Control. 2007 Dec;35(10 Suppl 2):S65-164
pubmed: 18068815
BMC Infect Dis. 2014 May 18;14:271
pubmed: 24885020
Epidemiol Infect. 1999 Apr;122(2):235-9
pubmed: 10355787
J Hosp Infect. 2011 Apr;77(4):285-9
pubmed: 21292349
J Infect Chemother. 2012 Apr;18(2):269-71
pubmed: 21894454
Rev Esp Quimioter. 2015 Apr;28(2):92-7
pubmed: 25904516
PLoS One. 2017 Jan 9;12(1):e0169425
pubmed: 28068356
Infect Control Hosp Epidemiol. 2018 Jan;39(1):90-93
pubmed: 29202897
J Hosp Infect. 2013 Mar;83(3):212-8
pubmed: 23332564
BMC Infect Dis. 2013 May 06;13:205
pubmed: 23641974
J Hosp Infect. 2011 Sep;79(1):75-89
pubmed: 21719149
J Clin Microbiol. 2007 Apr;45(4):1118-25
pubmed: 17267624
Lancet Infect Dis. 2005 Dec;5(12):751-62
pubmed: 16310147
Am J Infect Control. 2008 Sep;36(7):504-35
pubmed: 18786461
Lancet Infect Dis. 2008 May;8(5):289-301
pubmed: 18471774
J Infect Dis. 2008 May 1;197(9):1226-34
pubmed: 18422434
Arch Gerontol Geriatr. 2009 Sep-Oct;49(2):242-245
pubmed: 18977042
PLoS One. 2014 Feb 24;9(2):e89667
pubmed: 24586949
Med Care. 2013 Mar;51(3):205-15
pubmed: 23358388
J Infect Prev. 2015 Mar;16(2):58-66
pubmed: 28989403
Genome Med. 2016 Oct 3;8(1):102
pubmed: 27716432
Age Ageing. 2008 May;37(3):294-9
pubmed: 18270245
Clin Infect Dis. 2000 Dec;31(6):1414-22
pubmed: 11096012
J Infect Chemother. 2011 Oct;17(5):609-21
pubmed: 21327935
J Microbiol Immunol Infect. 2019 Feb;52(1):62-74
pubmed: 29530709
Infect Control Hosp Epidemiol. 2013 Mar;34(3):325-6
pubmed: 23388372
Infect Control Hosp Epidemiol. 2016 Jun;37(6):685-91
pubmed: 26941060