Comparison of the Methicillin-Resistant Staphylococcus aureus Acquisition among Rehabilitation and Nursing Home Residents

Autor: Jon P. Furuno, Simone M. Shurland, Min Zhan, J. Kristie Johnson, Richard A. Venezia, Anthony D. Harris, Mary-Claire Roghmann
Rok vydání: 2011
Předmět:
Zdroj: Infection Control & Hospital Epidemiology. 32:244-249
ISSN: 1559-6834
0899-823X
0195-9417
DOI: 10.1086/524177
Popis: Objective.To assess risk factors for methicillin-resistantStaphylococcus aureus(MRSA) acquisition among extended care residents focusing on level of care (residential vs rehabilitation) and room placement with an MRSA-positive resident.Design.Prospective cohort study.Setting.Extended care units at 2 healthcare systems in Maryland.Participants.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.Methods.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).Results.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 concordantspatyping, only 2 of 8 residents who acquired MRSA and had room placement with an MRSA-positive resident acquired their MRSA isolate from their roommate.Conclusion.Residents in rehabilitation care appear at higher risk and have different risk factors for MRSA acquisition compared to those in residential care.
Databáze: OpenAIRE
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