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MRSA
carriage rates vary widely in nursing homes,
study finds
December 1, 2010--A study published in the
January 2011 issue of Infection
Control and Hospital Epidemiology finds
that a high percentage of nursing home
residents carry Methicillin-resistant Staphylococcus
aureus (MRSA),
and suggests that some nursing homes could
be doing more to prevent the spread of the
bacteria, which can lead to hard-to-treat
infections.
The study, which looked at 10 nursing homes
in Orange County, California, found that 31
percent of the residents who were tested
were carrying MRSA (meaning they could pass
the bacteria along to others, but were not
necessarily sick with infection).
That rate
is substantially higher than rates found in
hospitals and even intensive care units,
according to Susan Huang, medical director
of epidemiology and infection prevention at
the University of California Irvine Medical
Center and one of the study's authors.
The study also found, however, that carriage
rates in each of the individual facilities
in the study varied widely, from a high of
52 percent in one facility to a low of 7
percent in another.
"The high overall levels of MRSA are reason
for concern," Huang said. "But the variation
in rates between facilities may be good news
because it suggests some facilities are
finding effective ways to contain the
bacteria."
Nursing homes have long been considered high
risk facilities for MRSA infections.
However, few studies have compared multiple
facilities in one area to look for variation
in MRSA carriage.
The researchers took nasal swabs from a
sample of 100 residents in each of the 10
homes. They also took samples from 50 people
at each home at the time they were admitted
to get an idea of how much MRSA was coming
into each facility.
The study found that a nursing home's rate
of MRSA carriage was not simply a result of
how much MRSA came in with new residents,
and suggests that some homes do a better job
than others of containing the bacteria once
it arrives.
For example, two nursing homes
in the study had identical MRSA intake rates
of 12 percent, but one of those homes had an
overall MRSA carriage among its established
residents of 22 percent, while the other had
a rate of 42 percent.
The next step, Huang said, is to find out
exactly what these facilities are doing to
better contain MRSA.
"The social environment in a nursing home
has a positive influence on residents, who
are encouraged to frequently mingle," Huang
said. "We don't want to stymie that
residential feel which can be very important
to mental and physical health, but we think
there's more to be learned about what
nursing homes can do to contain MRSA."
