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Methicillin-Resistant Staphylococcus aureus (MRSA) Nasal Carriage in Residents of Veterans Affairs Long-Term Care Facilities: Role of Antimicrobial Exposure and MRSA Acquisition
To identify risk factors associated with methicillin-resistant Staphylococcus aureus (MRSA) acquisition in long-term care facility (LTCF) residents. Multicenter, prospective cohort followed over 6 months. Three Veterans Affairs (VA) LTCFs. All current and new residents except those with short stay (
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| Published in: | Infection control and hospital epidemiology 2012-06, Vol.33 (6), p.551-557 |
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| container_end_page | 557 |
| container_issue | 6 |
| container_start_page | 551 |
| container_title | Infection control and hospital epidemiology |
| container_volume | 33 |
| creator | STONE, Nimalie D LEWIS, Donna R JOHNSON, Theodore M HARTNEY, Thomas CHANDLER, Doris BYRD-SELLERS, Johnita MCGOWAN, John E TENOVER, Fred C JERNIGAN, John A GAYNES, Robert P |
| description | To identify risk factors associated with methicillin-resistant Staphylococcus aureus (MRSA) acquisition in long-term care facility (LTCF) residents.
Multicenter, prospective cohort followed over 6 months.
Three Veterans Affairs (VA) LTCFs.
All current and new residents except those with short stay ( |
| doi_str_mv | 10.1086/665711 |
| format | article |
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Multicenter, prospective cohort followed over 6 months.
Three Veterans Affairs (VA) LTCFs.
All current and new residents except those with short stay (<2 weeks).
MRSA carriage was assessed by serial nares cultures and classified into 3 groups: persistent (all cultures positive), intermittent (at least 1 but not all cultures positive), and noncarrier (no cultures positive). MRSA acquisition was defined by an initial negative culture followed by more than 2 positive cultures with no subsequent negative cultures. Epidemiologic data were collected to identify risk factors, and MRSA isolates were typed by pulsed-field gel electrophoresis (PFGE).
Among 412 residents at 3 LTCFs, overall MRSA prevalence was 58%, with similar distributions of carriage at all 3 facilities: 20% persistent, 39% intermittent, 41% noncarriers. Of 254 residents with an initial negative swab, 25 (10%) acquired MRSA over the 6 months; rates were similar at all 3 LTCFs, with no clusters evident. Multivariable analysis demonstrated that receipt of systemic antimicrobials during the study was the only significant risk factor for MRSA acquisition (odds ratio, 7.8 [95% confidence interval, 2.1-28.6]; P = .002). MRSA strains from acquisitions were related by PFGE to those from a roommate in 9/25 (36%) cases; 6 of these 9 roommate sources were persistent carriers.
MRSA colonization prevalence was high at 3 separate VA LTCFs. MRSA acquisition was strongly associated with antimicrobial exposure. Roommate sources were often persistent carriers, but transmission from roommates accounted for only approximately one-third of MRSA acquisitions.</description><identifier>ISSN: 0899-823X</identifier><identifier>EISSN: 1559-6834</identifier><identifier>DOI: 10.1086/665711</identifier><identifier>PMID: 22561709</identifier><language>eng</language><publisher>Chicago, IL: University of Chicago Press</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents - adverse effects ; Bacterial diseases ; Biological and medical sciences ; Cross Infection - diagnosis ; Cross Infection - epidemiology ; Cross Infection - etiology ; Cross Infection - transmission ; Female ; Hospitals, Veterans ; Human bacterial diseases ; Humans ; Indexing in process ; Infection Control ; Infectious diseases ; Logistic Models ; Male ; Medical sciences ; Methicillin-Resistant Staphylococcus aureus - isolation & purification ; Middle Aged ; Miscellaneous ; Multivariate Analysis ; Nose - microbiology ; Nursing ; Prevalence ; Prospective Studies ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Residential Facilities ; Risk Factors ; Staphylococcal Infections - diagnosis ; Staphylococcal Infections - epidemiology ; Staphylococcal Infections - etiology ; Staphylococcal Infections - transmission ; Staphylococcal infections, streptococcal infections, pneumococcal infections ; Staphylococcus aureus</subject><ispartof>Infection control and hospital epidemiology, 2012-06, Vol.33 (6), p.551-557</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-86fc1427b4229d1643fa3a0c31273c8dbfe847e82749f5cb0e813e0e84ff51ab3</citedby><cites>FETCH-LOGICAL-c375t-86fc1427b4229d1643fa3a0c31273c8dbfe847e82749f5cb0e813e0e84ff51ab3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26224729$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22561709$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>STONE, Nimalie D</creatorcontrib><creatorcontrib>LEWIS, Donna R</creatorcontrib><creatorcontrib>JOHNSON, Theodore M</creatorcontrib><creatorcontrib>HARTNEY, Thomas</creatorcontrib><creatorcontrib>CHANDLER, Doris</creatorcontrib><creatorcontrib>BYRD-SELLERS, Johnita</creatorcontrib><creatorcontrib>MCGOWAN, John E</creatorcontrib><creatorcontrib>TENOVER, Fred C</creatorcontrib><creatorcontrib>JERNIGAN, John A</creatorcontrib><creatorcontrib>GAYNES, Robert P</creatorcontrib><creatorcontrib>Southeast Veterans Affairs Long-Term Care Methicillin-Resistant Staphylococcus aureus Cooperative</creatorcontrib><title>Methicillin-Resistant Staphylococcus aureus (MRSA) Nasal Carriage in Residents of Veterans Affairs Long-Term Care Facilities: Role of Antimicrobial Exposure and MRSA Acquisition</title><title>Infection control and hospital epidemiology</title><addtitle>Infect Control Hosp Epidemiol</addtitle><description>To identify risk factors associated with methicillin-resistant Staphylococcus aureus (MRSA) acquisition in long-term care facility (LTCF) residents.
Multicenter, prospective cohort followed over 6 months.
Three Veterans Affairs (VA) LTCFs.
All current and new residents except those with short stay (<2 weeks).
MRSA carriage was assessed by serial nares cultures and classified into 3 groups: persistent (all cultures positive), intermittent (at least 1 but not all cultures positive), and noncarrier (no cultures positive). MRSA acquisition was defined by an initial negative culture followed by more than 2 positive cultures with no subsequent negative cultures. Epidemiologic data were collected to identify risk factors, and MRSA isolates were typed by pulsed-field gel electrophoresis (PFGE).
Among 412 residents at 3 LTCFs, overall MRSA prevalence was 58%, with similar distributions of carriage at all 3 facilities: 20% persistent, 39% intermittent, 41% noncarriers. Of 254 residents with an initial negative swab, 25 (10%) acquired MRSA over the 6 months; rates were similar at all 3 LTCFs, with no clusters evident. Multivariable analysis demonstrated that receipt of systemic antimicrobials during the study was the only significant risk factor for MRSA acquisition (odds ratio, 7.8 [95% confidence interval, 2.1-28.6]; P = .002). MRSA strains from acquisitions were related by PFGE to those from a roommate in 9/25 (36%) cases; 6 of these 9 roommate sources were persistent carriers.
MRSA colonization prevalence was high at 3 separate VA LTCFs. MRSA acquisition was strongly associated with antimicrobial exposure. Roommate sources were often persistent carriers, but transmission from roommates accounted for only approximately one-third of MRSA acquisitions.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Bacterial Agents - adverse effects</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>Cross Infection - diagnosis</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - etiology</subject><subject>Cross Infection - transmission</subject><subject>Female</subject><subject>Hospitals, Veterans</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Indexing in process</subject><subject>Infection Control</subject><subject>Infectious diseases</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methicillin-Resistant Staphylococcus aureus - isolation & purification</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Multivariate Analysis</subject><subject>Nose - microbiology</subject><subject>Nursing</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Residential Facilities</subject><subject>Risk Factors</subject><subject>Staphylococcal Infections - diagnosis</subject><subject>Staphylococcal Infections - epidemiology</subject><subject>Staphylococcal Infections - etiology</subject><subject>Staphylococcal Infections - transmission</subject><subject>Staphylococcal infections, streptococcal infections, pneumococcal infections</subject><subject>Staphylococcus aureus</subject><issn>0899-823X</issn><issn>1559-6834</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNqNkc1u1DAUhS0EokOBR0DegMoi4N_EYReNWkCagjQtiF3kONetUcae2o5EH4s3xNEMsITNPZvvnCPdg9BzSt5Qouq3dS0bSh-gFZWyrWrFxUO0IqptK8X4txP0JKXvhJCmbeljdMKYrGlD2hX6eQn51hk3Tc5XW0guZe0zvsp6f3s_BROMmRPWc4QiZ5fbq-41_qSTnvBax-j0DWDn8WIcweeEg8VfIUPUPuHOWu1iwpvgb6priLvFA_hClzqXHaR3eBsmWDydz27nTAyDK9HnP_YhlUqs_YiXTtyZu9mlYgr-KXpk9ZTg2VFP0ZeL8-v1h2rz-f3HdbepDG9krlRtDRWsGQRj7Uhrwa3mmhhOWcONGgcLSjSgWCNaK81AQFEO5QprJdUDP0Vnh9x9DHczpNzvXDIwTdpDmFNPKZNMUC74f6LL8_-NEkolV7ImBX11QMtbUopg-310Ox3vC9Qvo_eH0Qv44pg5DzsY_2C_Vy7AyyOgk9GTLesYl_5yNWOiYS3_BcdFs8I</recordid><startdate>20120601</startdate><enddate>20120601</enddate><creator>STONE, Nimalie D</creator><creator>LEWIS, Donna R</creator><creator>JOHNSON, Theodore M</creator><creator>HARTNEY, Thomas</creator><creator>CHANDLER, Doris</creator><creator>BYRD-SELLERS, Johnita</creator><creator>MCGOWAN, John E</creator><creator>TENOVER, Fred C</creator><creator>JERNIGAN, John A</creator><creator>GAYNES, Robert P</creator><general>University of Chicago Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QL</scope><scope>7T7</scope><scope>7U1</scope><scope>7U2</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>P64</scope></search><sort><creationdate>20120601</creationdate><title>Methicillin-Resistant Staphylococcus aureus (MRSA) Nasal Carriage in Residents of Veterans Affairs Long-Term Care Facilities: Role of Antimicrobial Exposure and MRSA Acquisition</title><author>STONE, Nimalie D ; LEWIS, Donna R ; JOHNSON, Theodore M ; HARTNEY, Thomas ; CHANDLER, Doris ; BYRD-SELLERS, Johnita ; MCGOWAN, John E ; TENOVER, Fred C ; JERNIGAN, John A ; GAYNES, Robert P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-86fc1427b4229d1643fa3a0c31273c8dbfe847e82749f5cb0e813e0e84ff51ab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Bacterial Agents - adverse effects</topic><topic>Bacterial diseases</topic><topic>Biological and medical sciences</topic><topic>Cross Infection - diagnosis</topic><topic>Cross Infection - epidemiology</topic><topic>Cross Infection - etiology</topic><topic>Cross Infection - transmission</topic><topic>Female</topic><topic>Hospitals, Veterans</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Indexing in process</topic><topic>Infection Control</topic><topic>Infectious diseases</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methicillin-Resistant Staphylococcus aureus - isolation & purification</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Multivariate Analysis</topic><topic>Nose - microbiology</topic><topic>Nursing</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Residential Facilities</topic><topic>Risk Factors</topic><topic>Staphylococcal Infections - diagnosis</topic><topic>Staphylococcal Infections - epidemiology</topic><topic>Staphylococcal Infections - etiology</topic><topic>Staphylococcal Infections - transmission</topic><topic>Staphylococcal infections, streptococcal infections, pneumococcal infections</topic><topic>Staphylococcus aureus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>STONE, Nimalie D</creatorcontrib><creatorcontrib>LEWIS, Donna R</creatorcontrib><creatorcontrib>JOHNSON, Theodore M</creatorcontrib><creatorcontrib>HARTNEY, Thomas</creatorcontrib><creatorcontrib>CHANDLER, Doris</creatorcontrib><creatorcontrib>BYRD-SELLERS, Johnita</creatorcontrib><creatorcontrib>MCGOWAN, John E</creatorcontrib><creatorcontrib>TENOVER, Fred C</creatorcontrib><creatorcontrib>JERNIGAN, John A</creatorcontrib><creatorcontrib>GAYNES, Robert P</creatorcontrib><creatorcontrib>Southeast Veterans Affairs Long-Term Care Methicillin-Resistant Staphylococcus aureus Cooperative</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Infection control and hospital epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>STONE, Nimalie D</au><au>LEWIS, Donna R</au><au>JOHNSON, Theodore M</au><au>HARTNEY, Thomas</au><au>CHANDLER, Doris</au><au>BYRD-SELLERS, Johnita</au><au>MCGOWAN, John E</au><au>TENOVER, Fred C</au><au>JERNIGAN, John A</au><au>GAYNES, Robert P</au><aucorp>Southeast Veterans Affairs Long-Term Care Methicillin-Resistant Staphylococcus aureus Cooperative</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Methicillin-Resistant Staphylococcus aureus (MRSA) Nasal Carriage in Residents of Veterans Affairs Long-Term Care Facilities: Role of Antimicrobial Exposure and MRSA Acquisition</atitle><jtitle>Infection control and hospital epidemiology</jtitle><addtitle>Infect Control Hosp Epidemiol</addtitle><date>2012-06-01</date><risdate>2012</risdate><volume>33</volume><issue>6</issue><spage>551</spage><epage>557</epage><pages>551-557</pages><issn>0899-823X</issn><eissn>1559-6834</eissn><abstract>To identify risk factors associated with methicillin-resistant Staphylococcus aureus (MRSA) acquisition in long-term care facility (LTCF) residents.
Multicenter, prospective cohort followed over 6 months.
Three Veterans Affairs (VA) LTCFs.
All current and new residents except those with short stay (<2 weeks).
MRSA carriage was assessed by serial nares cultures and classified into 3 groups: persistent (all cultures positive), intermittent (at least 1 but not all cultures positive), and noncarrier (no cultures positive). MRSA acquisition was defined by an initial negative culture followed by more than 2 positive cultures with no subsequent negative cultures. Epidemiologic data were collected to identify risk factors, and MRSA isolates were typed by pulsed-field gel electrophoresis (PFGE).
Among 412 residents at 3 LTCFs, overall MRSA prevalence was 58%, with similar distributions of carriage at all 3 facilities: 20% persistent, 39% intermittent, 41% noncarriers. Of 254 residents with an initial negative swab, 25 (10%) acquired MRSA over the 6 months; rates were similar at all 3 LTCFs, with no clusters evident. Multivariable analysis demonstrated that receipt of systemic antimicrobials during the study was the only significant risk factor for MRSA acquisition (odds ratio, 7.8 [95% confidence interval, 2.1-28.6]; P = .002). MRSA strains from acquisitions were related by PFGE to those from a roommate in 9/25 (36%) cases; 6 of these 9 roommate sources were persistent carriers.
MRSA colonization prevalence was high at 3 separate VA LTCFs. MRSA acquisition was strongly associated with antimicrobial exposure. Roommate sources were often persistent carriers, but transmission from roommates accounted for only approximately one-third of MRSA acquisitions.</abstract><cop>Chicago, IL</cop><pub>University of Chicago Press</pub><pmid>22561709</pmid><doi>10.1086/665711</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0899-823X |
| ispartof | Infection control and hospital epidemiology, 2012-06, Vol.33 (6), p.551-557 |
| issn | 0899-823X 1559-6834 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1125241343 |
| source | Cambridge Journals Online |
| subjects | Adult Aged Aged, 80 and over Anti-Bacterial Agents - adverse effects Bacterial diseases Biological and medical sciences Cross Infection - diagnosis Cross Infection - epidemiology Cross Infection - etiology Cross Infection - transmission Female Hospitals, Veterans Human bacterial diseases Humans Indexing in process Infection Control Infectious diseases Logistic Models Male Medical sciences Methicillin-Resistant Staphylococcus aureus - isolation & purification Middle Aged Miscellaneous Multivariate Analysis Nose - microbiology Nursing Prevalence Prospective Studies Public health. Hygiene Public health. Hygiene-occupational medicine Residential Facilities Risk Factors Staphylococcal Infections - diagnosis Staphylococcal Infections - epidemiology Staphylococcal Infections - etiology Staphylococcal Infections - transmission Staphylococcal infections, streptococcal infections, pneumococcal infections Staphylococcus aureus |
| title | Methicillin-Resistant Staphylococcus aureus (MRSA) Nasal Carriage in Residents of Veterans Affairs Long-Term Care Facilities: Role of Antimicrobial Exposure and MRSA Acquisition |
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