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Characteristics That Promote Transmission of Staphylococcus aureus in German Nursing Homes

Published online by Cambridge University Press:  21 June 2016

C. Wendt ,
D. Svoboda ,
C. Schmidt ,
O. Bock-Hensley  and
H. von Baum
C. Wendt*
Affiliation:
Hygiene-Institut, University of Heidelberg, Heidelberg, Germany
D. Svoboda
Affiliation:
Hygiene-Institut, University of Heidelberg, Heidelberg, Germany
C. Schmidt
Affiliation:
Hygiene-Institut, University of Heidelberg, Heidelberg, Germany
O. Bock-Hensley
Affiliation:
Landratsamt Rhein-Neckar-Kreis, Gesundheitsamt, Heidelberg, Germany
H. von Baum
Affiliation:
Sektion Klinikhygiene, University of Ulm, Ulm, Germany
*
Hygiene-Institut, University of Heidelberg, INF 324, 69 120 Heidelberg, Germanyconstanze_wendt@med.uni-heidelberg.de
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Abstract

Objective:

To determine factors that influence transmission of Staphylococcus aureus in nursing homes in the Rhine-Neckar region of southern Germany.

Design:

Ecologie study.

Setting:

Forty-seven nursing homes in the region.

Participants:

Residents of the approached nursing homes who agreed to participate.

Methods:

Personal data and swabs of the nares were collected from participants. Swabs were examined for growth of S. aureus. All S. aureus isolates were typed using pulsed-field gel electrophoresis (PFGE). Transmission rates were calculated by dividing the number of transmissions (ie, cases in which two inhabitants shared the same PFGE type) by the number of S. aureus carriers. Characteristics of the nursing homes were correlated with a home's transmission rate.

Results:

In each nursing home, 12% to 54% of the residents were colonized with S. aureus. The transmission rates for the 47 nursing homes ranged from 0% to 70%. A linear regression model revealed that a stay in the nursing home of longer than 6 months and accommodation in a room with 3 or more beds were positively associated with the transmission rate. Receipt of antibiotics during the 4 weeks preceding the study was negatively associated with transmission.

Conclusions:

Stays beyond 6 months and accommodation in rooms with multiple beds are important for the transmission of S. aureus. One way to reduce transmission would be to design facilities with single and double rooms. However, the social needs of the residents must be evaluated and respected.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 10 , October 2005 , pp. 816 - 821
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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References

1.Fishbain, JT, Lee, JC, Nguyen, HD, et al.Nosocomial transmission of methicillin-resistant Staphylococcus aureus: a blinded study to establish baseline acquisition rates. Infect Control Hosp Epidemiol 2003;24:415–421.Google Scholar
2.Booth, CM, Matukas, LM, Tomlinson, GA, et al.Clinical features and short-term outcomes of 144 patients with SARS in the greater Toronto area. JAMA 2003;289:2801–2809.Google Scholar
3.Centers for Disease Control and Prevention (CDC). Tuberculosis outbreak in a community hospital: District of Columbia, 2002. MMWR 2004;53:214–216.Google Scholar
4.Dziekan, G, Hahn, A, Thune, K, et al.Methicillin-resistant Staphylococcus aureus in a teaching hospital: investigation of nosocomial transmission using a matched case-control study. J Hosp Infect 2000;46:263–270.Google Scholar
5.van der Sar-van der Brugge, S, Arend, SM, Bernards, AT, et al.Risk factors for acquisition of Serratia marcescens in a surgical intensive care unit. J Hosp Infect 1999;41:291–299.Google Scholar
6.Byers, KE, Anglim, AM, Anneski, CJ, et al.A hospital epidemic of vancomycin-resistant Enterococcus: risk factors and control. Infect Control Hosp Epidemiol 2001;22:140–147.CrossRefGoogle ScholarPubMed
7.Martinez, JA, Ruthazer, R, Hansjosten, K, Barefoot, L, Snydman, DR. Role of environmental contamination as a risk factor for acquisition of vancomycin-resistant enterococci in patients treated in a medical intensive care unit. Arch Intern Med 2003;163:1905–1912.Google Scholar
8.Farrington, M, Trundle, C, Redpath, C, et al.Effects on nursing workload of different methicillin-resistant Staphylococcus aureus (MRSA) control strategies. J Hosp Infect 2000;46:118–122.Google Scholar
9.Nishi, JI, Shirao, K, Ito, H, et al.Difference in incidence and transmission mode of methicillin-resistant Staphylococcus aureus among surgery, orthopedics, and pediatrics wards: a prospective study at a university hospital. Infect Control Hosp Epidemiol 1998;19:107–109.Google Scholar
10.Pfaller, M, Hollis, RJ, Sader, HS. PFGE of chromosomal DNA. In: Isenberg, HD, ed. Clinical Microbiological Procedures Handbook. Washington, DC: American Society for Microbiology; 1992:Section 10.5.c.Google Scholar
11.Mendelson, G, Yearmack, Y, Granot, E, et al.Staphylococcus aureus carrier state among elderly residents of a long-term care facility. J Am Med Dir Assoc 2003;4:125–127.Google Scholar
12.Jernigan, JA, Pullen, AL, Partin, C, Jarvis, WR. Prevalence of and risk factors for colonization with methicillin-resistant Staphylococcus aureus in an outpatient clinic population. Infect Control Hosp Epidemiol 2003;24:445–450.Google Scholar
13.Lee, YL, Cesario, TPax, A, et al.Nasal colonization by Staphylococcus aureus in active, independent, community seniors. Age Ageing 1999;28:229–232.Google Scholar
14.Jonas, D, Towner, KJ, Loerwald, M, et al.Diversity of Staphylococcus aureus strains isolated from two European regions with different prevalences of methicillin resistance. Eur J Clin Microbiol Infect Dis 2002;21:880–883.CrossRefGoogle ScholarPubMed
15.Kibbler, CC, Quick, KJ, O'Neill, AM. The effect of increased bed numbers on MRSA transmission in acute medical wards. J Hosp Infect 1998;39:213–219.CrossRefGoogle ScholarPubMed
16.Drinka, PJ, Krause, P, Nest, L, Goodman, BM, Gravenstein, S. Risk of acquiring influenza A in a nursing home from a culture-positive roommate. Infect Control Hosp Epidemiol 2003;24:872–874.Google Scholar
17.Muto, CA, Jernigan, JA, Ostrowsky, BE, et al.SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and enterococcus. Infect Control Hosp Epidemiol 2003;24:362–386.Google Scholar
18.von Baum, H, Schmidt, C, Svoboda, D, Bock-Hensley, O, Wendt, C. Risk factors for methicillin-resistant Staphylococcus aureus carriage in residents of German nursing homes. Infect Control Hosp Epidemiol 2002;23:511–515.Google Scholar
19.Rule, BG, Milke, DL, Dobbs, AR. Design of institutions: cognitive functioning and social interactions of the aged resident. J Appi Gerontol 1992;11:475–488.Google Scholar