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Risk Factors for Colonization With Methicillin-Resistant Staphylococcus aureus in a Long-Term-Care Facility in Slovenia

Published online by Cambridge University Press:  21 June 2016

Petra Vovko ,
Matjaz Retelj ,
Tjasa Zohar Cretnik ,
Borut Jutersek ,
Tatjana Harlander ,
Jana Kolman  and
Marija Gubina
Petra Vovko*
Affiliation:
Microbiology Department, Public Health Institute Novo mesto, Novo mesto, Slovenia
Matjaz Retelj
Affiliation:
Microbiology Department, Public Health Institute Novo mesto, Novo mesto, Slovenia
Tjasa Zohar Cretnik
Affiliation:
Microbiology Department, Public Health Institute Celje, Celje, Slovenia
Borut Jutersek
Affiliation:
Microbiology Department, Public Health Institute Celje, Celje, Slovenia
Tatjana Harlander
Affiliation:
Microbiology Department, Public Health Institute Novo mesto, Novo mesto, Slovenia
Jana Kolman
Affiliation:
University Medical Centre Ljubljana, Ljubljana, Slovenia
Marija Gubina
Affiliation:
Institute of Microbiology and Immunology, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
*
Microbiology Department, Public Health Institute Novo mesto, Mej vrti 5, SI-8000 Novo mesto, Slovenia. petra.vovko@zzv-nm.si
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Abstract

Objective:

To evaluate risk factors associated with methicillin-resistant Staphylococcus aureus (MRSA) colonization in a long-term-care facility (LTCF) for the elderly in Slovenia.

Setting:

A 351-bed community LTCF for the elderly.

Design and Participants:

This was a case-control study. MRSA carriage was identified in 102 of 127 residents of the facility's nursing unit. Two swabs were taken: one from the anterior nares and one from the largest skin lesion. If no skin lesions were present, the axillae and the groin area were swabbed. Data were collected regarding gender, age, length of stay in the facility, underlying conditions, functional status, presence of wounds or pressure sores, presence of catheters, antibiotic treatments, and hospital admissions.

Results:

We detected MRSA in 12 participants. Risk factors independently and significantly associated with MRSA colonization on the multivariate analysis were antibiotic treatments within 1 month before the investigation (odds ratio, 5.087; 95% confidence interval, 1.02 to 25.48; P = .048) and multiple hospital admissions in the 3 months before the investigation (odds ratio, 6.277; 95% confidence interval, 1.31 to 30.05; P = .022).

Conclusions:

This is the first assessment of risk factors for colonization with MRSA in an LTCF in Slovenia. MRSA poses a problem in this LTCF. Our observations may be valuable in implementing active surveillance cultures in infection control programs in Slovenian LTCFs.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 2 , February 2005 , pp. 191 - 195
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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References

1.Gross, PA, Levine, JF, LoPresti, A, Urdaneta, M. Infections in the elderly. In: Wenzel, RP, Willig, SH, eds. Prevention and Control of Nosocomial Infections. Baltimore, MD: Lippincott Williams & Wilkins; 1997:1059–1098.Google Scholar
2.Strausbaugh, LJ. Emerging health care-associated infections in the geriatric population. Emerg Infect Dis 2001;7:268–271.Google Scholar
3.Chambers, HF. The changing epidemiology of Staphylococcus aureus? Emerg Infect Dis 2001;7:178–182.CrossRefGoogle ScholarPubMed
4.Grundmann, H, Tami, A, Hori, S, Halwani, M, Slack, R. Nottingham Staphylococcus aureus population study: prevalence of MRSA among elderly people in the community. BMJ 2002;324:1365–1366.Google Scholar
5.Bengualid, V, Berger, J. Community-acquired methicillin-resistant Staphylococcus aureus. Clin Infect Dis 2003:37:466.Google Scholar
6.Salgado, CD, Farr, BM, Calfee, DP. Community-acquired methicillin-resistant Staphylococcus aureus: a meta-analysis of prevalence and risk factors. Clin Infect Dis 2003;36:131–139.Google Scholar
7.Mulligan, ME, Murray-Leisure, KA, Ribner, BS, et al.Methicillin-resistant Staphylococcus aureus: a consensus review of the microbiology, pathogenesis, and epidemiology with implications for prevention and management. Am J Med 1993;94:313–328.CrossRefGoogle ScholarPubMed
8.Murphy, S, Denman, S, Bennett, RG, et al.Methicillin-resistant Staphylococcus aureus colonization in a long-term-care facility. J Am GeriatrSoc 1992;40:213–217.Google Scholar
9.O'Sullivan, NP, Keane, CT. Risk factors for colonization with methicillin-resistant Staphylococcus aureus among nursing home residents. J Hosp Infect 2000;45:206–210.Google Scholar
10.Washio, M, Mizoue, T, Kajioka, T, et al.Risk factors for methicillin-resistant Staphylococcus aureus (MRSA) infection in a Japanese geriatric hospital. Public Health 1997;111:187–190.Google Scholar
11.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.CrossRefGoogle ScholarPubMed
12.Bradley, SF. Methicillin-resistant Staphylococcus aureus in nursing homes: epidemiology, prevention and management. Drugs Aging 1997;10:185–198.Google Scholar
13.Bradley, SF. Methicillin-resistant Staphylococcus aureus: long-term care concerns. Am J Med 1999;106:2S–10S.Google Scholar
14.Heudorf, U, Bremer, U, Heuck, D. MRSA colonization among residents of nursing homes, homes for the elderly, and a geriatric clinic in the city of Frankfurt am Main in 1999 [in German]. Gesundheitswesen 2001;63:447–454.CrossRefGoogle Scholar
15.Mulhausen, PL, Harrell, LJ, Weinberger, M, Kochersberger, GG, Feussner, JR. Contrasting methicillin-resistant Staphylococcus aureus colonization in Veterans Affairs and community nursing homes. Am J Med 1996;100:24–31.Google Scholar
16.Klavs, I, Bufon, LT, Skerl, M, et al.Prevalence of and risk factors for hospital-acquired infections in Slovenia: results of the first national survey, 2001. J Hosp Infect 2003;54:149–157.Google Scholar
17.European Antimicrobial Resistance Surveillance System. European Antimicrobial Resistance Surveillance System Annual Report 2001. Bilthoven, the Netherlands: European Antimicrobial Resistance Surveillance System; 2002.Google Scholar
18.Hussain, Z, Stoakes, L, Garrow, S, et al.Rapid detection of mecA-positive and mecA-negative coagulase-negative staphylococci by an anti-penicillin binding protein 2a slide latex agglutination test. J Clin Microbiol 2000;38:2051–2054.Google Scholar
19.Kluytmans, J, Van Griethuysen, A, Willemse, P, Van Keulen, P. Performance of CHROMagar selective medium and oxacillin resistance screening agar base for identifying Staphylococcus aureus and detecting methicillin resistance. J Clin Microbiol 2002;40:2480–2482.Google Scholar
20.National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Susceptibility Testing. Wayne, PA: National Committee for Clinical Laboratory Standards; 2000. Approved standard M100-S10.Google Scholar
21.National Committee for Clinical Laboratory Standards. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. Wayne, PA: National Committee for Clinical Laboratory Standards; 2000. Approved standard M7-A5.Google Scholar
22.Simor, AE, Goodfellow, J, Louie, L, Louie, M. Evaluation of new medium, oxacillin resistance screening agar base, for the detection of methicillin-resistant Staphylococcus aureus from clinical specimens. J Clin Microbiol 2001;39:3422.Google Scholar
23.Boult, C. Comprehensive geriatric assessment. In: Beers, MH, Berkow, R, eds. The Merck Manual of Geriatrics. Whitehouse Station, NJ: Merck Research Laboratories; 2000.Google Scholar
24.Armitage, P, Berry, G. Statistical Methods in Medical Research. Oxford: Blackwell Publications; 1994.Google Scholar
25.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
26.Girou, E, Pujade, G, Legrand, P, Cizeau, F, Brun-Buisson, C. Selective screening of carriers for control of methicillin-resistant Staphylococcus aureus (MRSA) in high-risk hospital areas with a high level of endemic MRSA. Clin Infect Dis 1998;27:543–550.Google Scholar
27.Chaix, C, Durand-Zaleski, I, Alberti, C, Brun-Buisson, C. Control of endemic methicillin-resistant Staphylococcus aureus: a cost-benefit analysis in an intensive care unit. JAMA 1999;282:1745–1751.CrossRefGoogle Scholar
28.Harbarth, S, Martin, Y, Rohner, P, et al.Effect of delayed infection control measures on a hospital outbreak of methicillin-resistant Staphylococcus aureus. J Hosp Infect 2000;46:43–49.CrossRefGoogle ScholarPubMed
29.Karchmer, TB, Durbin, LJ, Simonton, BM, Farr, BM. Cost-effectiveness of active surveillance cultures and contact/droplet precautions for control of methicillin-resistant Staphylococcus aureus. J Hosp Infect 2002; 51:126–132.Google Scholar
30.Boyce, JM. Understanding and controlling methicillin-resistant Staphylococcus aureus infections. Infect Control Hosp Epidemiol 2002; 23:485–487.CrossRefGoogle ScholarPubMed
31.Hennekens, CH, Buring, JE. Epidemiology in Medicine. Boston: Little, Brown; 1987.Google Scholar
32.Lee, YL, Gupta, G, Cesario, T, et al.Colonization by Staphylococcus aureus resistant to methicillin and ciprofloxacin during 20 months' surveillance in a private skilled nursing facility. Infect Control Hosp Epidemiol 1996;17:649–653.Google Scholar
33.Niclaes, L, Buntinx, F, Banuro, F, Lesaffre, E, Heyrman, J. Consequences of MRSA carriage in nursing home residents. Epidemiol Infect 1999; 122:235–239.Google Scholar
34.Bradley, SF, Terpenning, MS, Ramsey, MA, et al.Methicillin-resistant Staphylococcus aureus: colonization and infection in a long-term care facility. Ann Intern Med 1991;115:417–422.Google Scholar
35.Washio, M, Nishisaka, S, Kishikawa, K, et al.Incidence of methicillin-resistant Staphylococcus aureus (MRSA) isolation in a skilled nursing home: a third report on the risk factors for the occurrence of MRSA infection in the elderly. J Epidemiol 1996;6:69–73.Google Scholar
36.Troillet, N, Carmeli, Y, Samore, MH, et al.Carriage of methicillin-resistant Staphylococcus aureus at hospital admission. Infect Control Hosp Epidemiol 1998;19:181–185.Google Scholar
37.Ostrowsky, BE, Trick, WE, Sohn, AH, et al.Control of vancomycin-resistant enterococcus in health care facilities in a region. N Engl J Med 2001;344:1427–1433.Google Scholar
38.Armstrong-Evans, M, Litt, M, McArthur, MA, et al.Control of transmission of vancomycin-resistant Enterococcus faecium in a long-term-care facility. Infect Control Hosp Epidemiol 1999;20:312–317.CrossRefGoogle ScholarPubMed
39.Silverblatt, FJ, Tibert, C, Mikolich, D, et al.Preventing the spread of vancomycin-resistant enterococci in a long-term care facility. J Am Geriatr Soc 2000;48:1211–1215.Google Scholar
40.Heuck, D, Nassauer, A. Methicillin-resistant Staphylococcus aureus in Altenund Pflegeheimen. Hygiene und Medizin 1999;24:72–80.Google Scholar