The general status of patients and limited physical activity as risk factors of Methicillin-resistant Staphylococcus aureus occurrence in long-term care facilities residents in Krakow, Poland

Abstract

Background: The aim of this study was to investigate the epidemiology and resistance of methicillin-resistant Staphylococcus aureus (MRSA) isolates from long-term care facilities (LTCF) residents and to analyze the potential risk factors for MRSA occurrence, defined as MRSA colonization and/or infection.

Methods: Point prevalence (PPS) and prospective incidence continuous study (CS) was carried out on a group of 193 residents in 2009-2010.

Results: Overall MRSA occurred (with or without infection) among 17.6% of residents. There was 16 cases of infections with SA aetiology, of which 10 (58.8%) were caused by MRSA. The MRSA prevalence in PPS was 12.9%, in CS infection incidence rate was 5.2%. Factors associated with MRSA occurrence were: general status of patients, limited physical activity, wound infections (odds ratio, OR 4.6), ulcers in PPS (OR 2.1), diabetes (OR 1.6), urinary catheterization (OR 1.6) and stool incontinence (OR 1.2).

Conclusions: Our data indicate a need for screening of MRSA before hospitalization or transfer to rehabilitation centres, especially in a group of residents with limitations in physical activity - i.e. with the highest risk of MRSA. Results also suggest the need for contact precautions in patients with high risk of MRSA occurrence, only. Focus on the high-risk population might be a solution for the cost-effective surveillance.

Figure 1

Pulsed-field gel electrophoresis (PFGE) dendrogram of methycillin-resistant Staphylococcus aureus isolates from the long-term care facilities residents (NH – Nursing Home, RH – Residential Home). PFGE clusters with >92% similarity are indicated.