OBJECTIVE: To assess risk factors for methicillin-resistant Staphylococcus aureus (MRSA) acquisition among extended care residents focusing on level of care (residential vs rehabilitation) and room placement with an MRSA-positive resident. DESIGN: Prospective cohort study. SETTING: Extended care units at 2 healthcare systems in Maryland. PARTICIPANTS: Four hundred forty-three residents with no history of MRSA and negative MRSA surveillance cultures of the anterior nares and areas of skin breakdown at enrollment. METHODS: Follow-up cultures were collected every 4 weeks and/or at discharge for a period of 12 weeks. Study data were collected by a research nurse from the medical staff and the electronic medical records. Cox proportional hazards modeling was used to calculate adjusted hazards ratios (aHRs) and 95% confidence intervals (CIs). RESULTS: Residents in rehabilitation care had 4-fold higher risk of MRSA acquisition compared with residents in residential care (hazard ratio [HR], 4. [95% CI, 2.2-8.8]). Being bedbound was significantly associated with MRSA acquisition in both populations (residential care, aHR, 4.3 [95% CI, 1.5-12.2]; rehabilitation care, aHR, 4.8 [95% CI, 1.2-18.7]). Having an MRSA-positive roommate was not significantly associated with acquisition in either population (residential care, aHR, 1.4 [95% CI, 0.5-3.9]; rehabilitation care, aHR, 0.5 [95% CI, 0.1-2.2]); based on concordant spa typing, only 2 of 8 residents who acquired MRSA and had room placement with an MRSA-positive resident acquired their MRSA isolate from their roommate. CONCLUSION: Residents in rehabilitation care appear at higher risk and have different risk factors for MRSA acquisition compared to those in residential care.
OBJECTIVE: To assess risk factors for methicillin-resistant Staphylococcus aureus (MRSA) acquisition among extended care residents focusing on level of care (residential vs rehabilitation) and room placement with an MRSA-positive resident. DESIGN: Prospective cohort study. SETTING: Extended care units at 2 healthcare systems in Maryland. PARTICIPANTS: Four hundred forty-three residents with no history of MRSA and negative MRSA surveillance cultures of the anterior nares and areas of skin breakdown at enrollment. METHODS: Follow-up cultures were collected every 4 weeks and/or at discharge for a period of 12 weeks. Study data were collected by a research nurse from the medical staff and the electronic medical records. Cox proportional hazards modeling was used to calculate adjusted hazards ratios (aHRs) and 95% confidence intervals (CIs). RESULTS: Residents in rehabilitation care had 4-fold higher risk of MRSA acquisition compared with residents in residential care (hazard ratio [HR], 4. [95% CI, 2.2-8.8]). Being bedbound was significantly associated with MRSA acquisition in both populations (residential care, aHR, 4.3 [95% CI, 1.5-12.2]; rehabilitation care, aHR, 4.8 [95% CI, 1.2-18.7]). Having an MRSA-positive roommate was not significantly associated with acquisition in either population (residential care, aHR, 1.4 [95% CI, 0.5-3.9]; rehabilitation care, aHR, 0.5 [95% CI, 0.1-2.2]); based on concordant spa typing, only 2 of 8 residents who acquired MRSA and had room placement with an MRSA-positive resident acquired their MRSA isolate from their roommate. CONCLUSION: Residents in rehabilitation care appear at higher risk and have different risk factors for MRSA acquisition compared to those in residential care.
Authors: R S McClelland; V G Fowler; L L Sanders; G Gottlieb; L K Kong; D J Sexton; K Schmader; K D Lanclos; R Corey Journal: Arch Intern Med Date: 1999-06-14
Authors: Simone M Shurland; O Colin Stine; Richard A Venezia; Jennifer K Johnson; Min Zhan; Jon P Furuno; Ram R Miller; Tamara Johnson; Mary-Claire Roghmann Journal: Infect Control Hosp Epidemiol Date: 2009-04 Impact factor: 3.254
Authors: Jean-Christophe Lucet; Karine Grenet; Laurence Armand-Lefevre; Marion Harnal; Elisabeth Bouvet; Bernard Regnier; Antoine Andremont Journal: Infect Control Hosp Epidemiol Date: 2005-02 Impact factor: 3.254
Authors: Jon P Furuno; Joan N Hebden; Harold C Standiford; Eli N Perencevich; Ram R Miller; Anita C Moore; Sandra M Strauss; Anthony D Harris Journal: Am J Infect Control Date: 2008-09 Impact factor: 2.918
Authors: R R Muder; C Brennen; M M Wagener; R M Vickers; J D Rihs; G A Hancock; Y C Yee; J M Miller; V L Yu Journal: Ann Intern Med Date: 1991-01-15 Impact factor: 25.391
Authors: S F Bradley; M S Terpenning; M A Ramsey; L T Zarins; K A Jorgensen; W S Sottile; D R Schaberg; C A Kauffman Journal: Ann Intern Med Date: 1991-09-15 Impact factor: 25.391
Authors: Susan L Mitchell; Michele L Shaffer; Mark B Loeb; Jane L Givens; Daniel Habtemariam; Dan K Kiely; Erika D'Agata Journal: JAMA Intern Med Date: 2014-10 Impact factor: 21.873
Authors: Robin L P Jump; Swati Gaur; Morgan J Katz; Christopher J Crnich; Ghinwa Dumyati; Muhammad S Ashraf; Elizabeth Frentzel; Steven J Schweon; Philip Sloane; David Nace Journal: J Am Med Dir Assoc Date: 2017-09-19 Impact factor: 4.669
Authors: Courtney R Murphy; Samantha J Eells; Victor Quan; Diane Kim; Ellena Peterson; Loren G Miller; Susan S Huang Journal: J Am Geriatr Soc Date: 2012-06-05 Impact factor: 5.562
Authors: Christopher J Crnich; Megan Duster; Timothy Hess; David R Zimmerman; Paul Drinka Journal: Infect Control Hosp Epidemiol Date: 2012-09-21 Impact factor: 3.254
Authors: Alison D Lydecker; Patience A Osei; Lisa Pineles; J Kristie Johnson; Jacquelyn Meisel; O Colin Stine; Laurence Magder; Ayse P Gurses; Joan Hebden; Cagla Oruc; Lona Mody; Kara Jacobs Slifka; Nimalie D Stone; Mary-Claire Roghmann Journal: Infect Control Hosp Epidemiol Date: 2020-10-20 Impact factor: 3.254