Colonization by Staphylococcus species resistant to methicillin or quinolone on hands of medical personnel in a skilled-nursing facility.

We report here a pilot survey of colonization with methicillin- and/or ciprofloxacin-resistant Staphylococcus species on hands of nursing personnel in a private skilled-nursing facility. We found only one nurses aide who carried methicillin-resistant Staphylococcus aureus and one who carried ciprofloxacin-resistant S. aureus, each on only one of the surveys. None of the control nonmedical personnel were found to carry methicillin-resistant S. aureus or ciprofloxacin-resistant S. aureus. The colonization rate of methicillin-resistant coagulase-negative staphylococci on the hands of medical personnel was 59%, compared with 13% for the nonmedical personnel, and the counts of methicillin-resistant coagulase-negative staphylococci were also significantly higher for nursing personnel. For ciprofloxacin-resistant coagulase-negative staphylococci, 30% of nursing personnel had positive cultures whereas no ciprofloxacin-resistant coagulase-negative staphylococci strains were recovered from the nonmedical control cohort. Three of the patients had presumptive infections with methicillin- or ciprofloxacin-resistant coagulase-negative staphylococci, all urinary tract infections. Personnel hands represent a likely mode of transmission of such strains between patients, and skilled-nursing facility patients may represent a reservoir for carrying the coagulase-negative staphylococci back to acute care facilities.