Comparison of the Methicillin-Resistant Staphylococcus aureus Acquisition among Rehabilitation and Nursing Home Residents
| Autor: | Min Zhan, Jon P. Furuno, Mary-Claire Roghmann, Anthony D. Harris, Richard A. Venezia, J. Kristie Johnson, Simone M. Shurland |
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| Rok vydání: | 2011 |
| Předmět: |
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Bacterial Male Methicillin-Resistant Staphylococcus aureus Microbiology (medical) medicine.medical_specialty Epidemiology Kaplan-Meier Estimate medicine.disease_cause Rehabilitation Centers Article Risk Factors Patients' Rooms Health care medicine Humans Infection control Prospective Studies Risk factor Intensive care medicine Aged Proportional Hazards Models Aged 80 and over Cross Infection business.industry Public health Guideline Middle Aged Staphylococcal Infections Methicillin-resistant Staphylococcus aureus Nursing Homes Infectious Diseases Extended care Female business |
| Zdroj: | Infection Control & Hospital Epidemiology. 32:244-249 |
| ISSN: | 1559-6834 0899-823X 0195-9417 |
| DOI: | 10.1086/658667 |
| Popis: | Objective.To assess risk factors for methicillin-resistant Staphylococcus 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 concordant spa typing, 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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