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Colonization Sites of USA300 Methicillin-Resistant Staphylococcus aureus in Residents of Extended Care Facilities

Published online by Cambridge University Press:  02 January 2015

Simone M. Shurland
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
O. Colin Stine
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
Richard A. Venezia
Affiliation:
Pathology, Baltimore, Maryland
Jennifer K. Johnson
Affiliation:
Pathology, Baltimore, Maryland
Min Zhan
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
Jon P. Furuno
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
Ram R. Miller
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
Tamara Johnson
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
Mary-Claire Roghmann*
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland University of Maryland School of Medicine, and Veterans Affairs Maryland Health Care System, Baltimore, Maryland
*
100 N. Greene St., Lower Level, Baltimore, MD 21201 (mroghman@epi.umaryland.edu)

Abstract

Background.

The anterior nares are the most sensitive single site for detecting methicillin-resistant Staphylococcus aureus (MRSA) colonization. Colonization patterns of USA300 MRSA colonization are unknown.

Objectives.

To assess whether residents of extended care facilities who are colonized with USA300 MRSA have different nares or skin colonization findings, compared with residents who are colonized with non-USA300 MRSA strains.

Methods.

The study population included residents of 5 extended care units in 3 separate facilities who had a recent history of MRSA colonization. Specimens were obtained weekly for surveillance cultures from the anterior nares, perineum, axilla, and skin breakdown (if present) for 3 weeks. MRSA isolates were categorized as USA300 MRSA or non-USA300 MRSA.

Results.

Of the 193 residents who tested positive for MRSA, 165 were colonized in the anterior nares, and 119 were colonized on their skin. Eighty-four percent of USA300 MRSA-colonized residents had anterior nares colonization, compared with 86% of residents colonized with non-USA300 MRSA (P = .80). Sixty-six percent of USA300 MRSA–colonized residents were colonized on the skin, compared with 59% of residents colonized with non-USA300 MRSA (P = .30).

Conclusions.

Colonization patterns of USA300 MRSA and non-USA300 MRSA are similar in residents of extended care facilities. Anterior nares cultures will detect most—but not all—people who are colonized with MRSA, regardless of whether it is USA300 or non-USA300 MRSA.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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