Prevalence of Methicillin‐Resistant Staphylococcus aureus Colonization in Residents and Staff in Nursing Homes in Northern Ireland

Abstract

OBJECTIVES: To determine the prevalence of, and factors associated with, methicillin‐resistant Staphylococcus aureus (MRSA) colonization in residents and staff in nursing homes in one geographically defined health administration area of Northern Ireland. DESIGN: Point prevalence study. SETTING: Nursing homes. PARTICIPANTS: Residents and staff in nursing homes. MEASUREMENTS: Nasal swabs were taken from all consenting residents and staff. If relevant, residents also provided urine samples, and swabs were taken from wounds and indwelling devices. RESULTS: A total of 1,111 residents (66% of all residents) and 553 staff (86% of available staff) in 45 nursing homes participated. The combined prevalence rate of MRSA in the resident population was 23.3% (95% confidence interval (CI)=18.8–27.7%) and 7.5% in staff (95% CI=5.1–9.9%). Residents who lived in nursing homes that were part of a chain were more likely to be colonized with MRSA (odds ratio (OR)=1.91, 95% CI=1.21–3.02) than those living in independently owned facilities. Residents were also more likely to be colonized if they lived in homes in which more than 12.5% of all screened healthcare staff (care assistants and nurses) were colonized with MRSA (OR=2.46, 95% CI=1.41–4.29) or if they lived in homes in which more than 15% of care assistants were colonized with MRSA (OR=2.64, 95% CI=1.58–4.42). CONCLUSION: The findings suggest that there is substantial colonization of MRSA in nursing home residents and staff in this one administrative health area. Implementation of infection control strategies should be given high priority in nursing homes.

Current prevalence of multidrug-resistant organisms in long-term care facilities in the Rhine-Main district, Germany, 2013

“…The MRSA prevalence we observed was lower than in MRSA surveys in recent years in the US [41][42][43][44][45], China [46], the UK [16], France [20], Ireland [15], and Italy [24], but higher than in the Netherlands and Sweden [14,22] (Table 3). …”

“…MDRO are regarded as a potentially serious threat to elderly people living in long-term care facilities (LTCFs). Although various studies on the prevalence of MRSA in LTCFs in Germany [7][8][9][10][11][12][13] and other European countries [14][15][16][17][18][19][20][21][22][23][24][25] have been published (< 1% in the Netherlands and Sweden, > 20% in Ireland and the United Kingdom (UK)), studies on the prevalence of MRGN such as extended-spectrum betalactamase (ESBL)-producing Enterobacteriaceae and vancomycin-resistant enterococci (VRE) among nursing home residents in German and in European LTCFs are scarce [7,14,24,26,27]. Although an increasing trend in the occurrence of ESBL-producing Enterobacteriaceae and even CRO is found in hospitals all over Europe [1,3,28,29], a lack of knowledge on multidrug-resistant organisms (MDRO) in nursing homes has to be stated.…”

Methicillin-resistant Staphylococcus aureus infection in Riveira (Galicia-North West of Spain). Impact of a nursing home MRSA control program on hospital admissions

“…Both MRSA prevalence in residents and care workers in our study are clearly lower than other reported by Baldwin et al, In this study the prevalence of MRSA carriers among residents was 23.3% and 7.5% in HCWs [27].…”

Colonization with Staphylococcus aureus in Swedish nursing homes: A cross-sectional study

“…In these areas, the proportion of invasive MRSA versus invasive MSSA may be as high as one in every two laboratory samples [6], and the parallel proportion of colonization-related MRSA versus colonization-related MSSA as high as one in every four isolates [15].…”