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Prevalence of Methicillin-Resistant Staphylococcus aureus Colonization Among Older Residents of Care Homes in the United Kingdom

Published online by Cambridge University Press:  02 January 2015

Benjamin Barr ,
Mark H. Wilcox ,
Angela Brady ,
Peter Parnell ,
Bob Darby  and
David Tompkins
Benjamin Barr*
Affiliation:
West Lancashire PCT, Ormskirk and District General Hospital, Lancashire, Leeds, United Kingdom
Mark H. Wilcox
Affiliation:
Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
Angela Brady
Affiliation:
Leeds North East PCT, Leeds, United Kingdom
Peter Parnell
Affiliation:
Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
Bob Darby
Affiliation:
Leeds North East PCT, Leeds, United Kingdom
David Tompkins
Affiliation:
Health Protection Agency, Yorkshire and the Humber, Leeds, United Kingdom
*
West Lancashire PCT, Ormskirk and District General Hospital, Wigan Road, Ormskirk, Lancashire L39 2IW, United Kingdom (ben@benbarr.wanadoo.co.uk)
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Abstract

Objective.

To determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization among older residents of care homes in Leeds, United Kingdom, and to identify resident and care home risk factors for carriage.

Design.

We conducted a cross-sectional prevalence survey of 715 residents from 39 care homes. All participants were tested for nasal colonization with S. aureus, including MRSA. A short questionnaire was completed about each participant and each care home. A multivariable model was used to determine which risk factors were independently associated with MRSA colonization.

Setting.

Care homes for older residents in Leeds, United Kingdom.

Participants.

All residents in participating homes who were able to give informed consent.

Results.

A total of 159 of 715 residents tested positive for MRSA, for a prevalence of 22% (95% confidence interval, 18%—27%) The resultant multivariate model showed that residence in a home with a low ratio of nurses to beds, residence in a care home in a deprived area, male sex, presence of an invasive device, and a hospitalization duration of more than 10 days during the previous 2 years were independently associated with MRSA colonization.

Conclusions.

This study found a large reservoir of MRSA within the care home population. Control strategies need to be coordinated between care homes and hospitals. Increasing the ratio of nurses to beds, reducing the duration of hospitalization, and improving the management of invasive devices could help reduce the prevalence of MRSA colonization. Further research is required to ascertain the potential health benefits of reducing the rate of MRSA colonization among care home residents.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 7 , July 2007 , pp. 853 - 859
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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