Screening for methicillin-resistant Staphylococcus aureus (MRSA) carriage on admission to a geriatric hospital

• Published in: Archives of gerontology and geriatrics 2009-09, Vol.49 (2), p.242-245
• Main Authors: Nishikawa, Mitsunori, Tanaka, Tomoko, Nakashima, Kazumitsu, Senda, Kazuyoshi, Shibasaki, Masataka, Miura, Hisayuki, Tamakoshi, Akiko, Ohta, Toshiki, Yagi, Tetsuya
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Anal Canal - microbiology; Carriage of MRSA by elderly; Carrier State - diagnosis; Carrier State - epidemiology; Carrier State - microbiology; Diagnostic Tests, Routine; Female; Geriatric hospitals; Geriatrics; Hospitalization; Hospitals, Special; Humans; Hypoalbuminemia; Immobilization; Infection control; Internal Medicine; Male; Methicillin-resistant Staphylococcus aureus (MRSA); Methicillin-Resistant Staphylococcus aureus - isolation & purification; MRSA; Nasal Cavity - microbiology; Population Surveillance; Risk Factors; Risk factors of MRSA; Screening; Staphylococcus aureus
• ISSN: 0167-4943; 1872-6976
• DOI: 10.1016/j.archger.2008.08.012

Abstract Our objective is to identify risk factors for carriage of MRSA on admission to a geriatric hospital where MRSA is endemic. A prospective screening for MRSA carriage was conducted by swabbing anterior nares and anal skin for 6 weeks. One hundred and thirty-eight patients aged over 65 were enrolled after obtaining their informed consent. Swabs of anterior nares and anal skin of patients were submitted for culture for MRSA. The demographic, administrative, and clinical data for each participant were recorded, and their association with MRSA carriage was determined by stepwise regression analysis. MRSA was recovered from 11 patients (11/138 patients, 8.0%), and from anal skin in 8 of them. Without screening of anal skin, 5 out of 11 carriers had been missed. Multivariate analysis revealed that hypoalbuminemia (adjusted risk ratio, RR = 6.39, 95% confidence interval, CI = 1.08–37.84) and bedridden status (RR = 8.26, CI = 1.04–65.31) were independent risk factors. Screening of elderly patients for gastrointestinal colonization on admission had implications for early detection of the reservoir of MRSA. Systematic selective screening for MRSA carriage targeting high-risk patients with hypoalbuminemia or bedridden status would be useful for infection control of this resistant organism.