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. 2013 May 6:13:205.
doi: 10.1186/1471-2334-13-205.

Transmission of methicillin-resistant Staphylococcus aureus in the long term care facilities in Hong Kong

Vincent C C Cheng  1 , Josepha W M Tai, Zoie S Y Wong, Jonathan H K Chen, Kris B Q Pan, Yizchen Hai, Wing-Chun Ng, Denise M K Chow, Miranda C Y Yau, Jasper F W Chan, Sally C Y Wong, Herman Tse, Sophia S C Chan, Kwok-Leung Tsui, Felix H W Chan, Pak-Leung Ho, Kwok-Yung Yuen
Affiliations

Transmission of methicillin-resistant Staphylococcus aureus in the long term care facilities in Hong Kong

Vincent C C Cheng et al. BMC Infect Dis. .

Abstract

Background: The relative contribution of long term care facilities (LTCFs) and hospitals in the transmission of methicillin-resistant Staphylococcus aureus (MRSA) is unknown.

Methods: Concurrent MRSA screening and spa type analysis was performed in LTCFs and their network hospitals to estimate the rate of MRSA acquisition among residents during their stay in LTCFs and hospitals, by colonization pressure and MRSA transmission calculations.

Results: In 40 LTCFs, 436 (21.6%) of 2020 residents were identified as 'MRSA-positive'. The incidence of MRSA transmission per 1000-colonization-days among the residents during their stay in LTCFs and hospitals were 309 and 113 respectively, while the colonization pressure in LTCFs and hospitals were 210 and 185 per 1000-patient-days respectively. MRSA spa type t1081 was the most commonly isolated linage in both LTCF residents (76/121, 62.8%) and hospitalized patients (51/87, 58.6%), while type t4677 was significantly associated with LTCF residents (24/121, 19.8%) compared with hospitalized patients (3/87, 3.4%) (p<0.001). This suggested continuous transmission of MRSA t4677 among LTCF residents. Also, an inverse linear relationship between MRSA prevalence in LTCFs and the average living area per LTCF resident was observed (Pearson correlation -0.443, p=0.004), with the odds of patients acquiring MRSA reduced by a factor of 0.90 for each 10 square feet increase in living area.

Conclusions: Our data suggest that MRSA transmission was more serious in LTCFs than in hospitals. Infection control should be focused on LTCFs in order to reduce the burden of MRSA carriers in healthcare settings.

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Figures

Figure 1
Figure 1
Overview of the MRSA colonization among LTCF residents and hospitalized LTCF residents in the healthcare region, Hong Kong West. Note. LTCFs, Long term care facilities.
Figure 2
Figure 2
Overview of the logistic of follow up analysis in both LTCF residents and hospitalized patients recruited in our study.
Figure 3
Figure 3
The relationship between the MRSA prevalence per LTCF and the average living area (square feet per person) per LTCF resident. Note. Pearson correlation of MRSA prevalence per LTCFs and area (square feet) per person = −0.443 (p = 0.004).
See this image and copyright information in PMC

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