Nursing home characteristics associated with methicillin-resistant Staphylococcus aureus (MRSA) Burden and Transmission

Courtney R. Murphy, Victor Quan, Diane Kim, Ellena Peterson, Matthew Whealon, Grace Tan, Kaye Evans, Hildy Meyers, Michele Cheung, Bruce Y. Lee, Dana B. Mukamel, Susan S. Huang

Research output: Contribution to journalArticle

Abstract

Background: MRSA prevalence in nursing homes often exceeds that in hospitals, but reasons for this are not well understood. We sought to measure MRSA burden in a large number of nursing homes and identify facility characteristics associated with high MRSA burden.Methods: We performed nasal swabs of residents from 26 nursing homes to measure MRSA importation and point prevalence, and estimate transmission. Using nursing home administrative data, we identified facility characteristics associated with MRSA point prevalence and estimated transmission risk in multivariate models.Results: We obtained 1,649 admission and 2,111 point prevalence swabs. Mean MRSA point prevalence was 24%, significantly higher than mean MRSA admission prevalence, 16%, (paired t-test, p<0.001), with a mean estimated MRSA transmission risk of 16%.In multivariate models, higher MRSA point prevalence was associated with higher admission prevalence (p=0.005) and higher proportions of residents with indwelling devices (p=0.01). Higher estimated MRSA transmission risk was associated with higher proportions of residents with diabetes (p=0.01) and lower levels of social engagement (p=0.03).Conclusions: MRSA importation was a strong predictor of MRSA prevalence, but MRSA burden and transmission were also associated with nursing homes caring for more residents with chronic illnesses or indwelling devices. Frequent social interaction among residents appeared to be protective of MRSA transmission, suggesting that residents healthy enough to engage in group activities do not incur substantial risks of MRSA from social contact. Identifying characteristics of nursing homes at risk for high MRSA burden and transmission may allow facilities to tailor infection control policies and interventions to mitigate MRSA spread.

Original languageEnglish (US)
Article number269
JournalBMC infectious diseases
Volume12
DOIs
StatePublished - Oct 24 2012

Keywords

  • Healthcare-associated infection
  • Long-term care
  • MRSA
  • Nursing home

ASJC Scopus subject areas

  • Infectious Diseases

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    Murphy, C. R., Quan, V., Kim, D., Peterson, E., Whealon, M., Tan, G., Evans, K., Meyers, H., Cheung, M., Lee, B. Y., Mukamel, D. B., & Huang, S. S. (2012). Nursing home characteristics associated with methicillin-resistant Staphylococcus aureus (MRSA) Burden and Transmission. BMC infectious diseases, 12, [269]. https://doi.org/10.1186/1471-2334-12-269