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Methicillin-resistant Staphylococcus aureus infection in a community hospital and the impact of a nursing home opening in its influence area

Abstract number: 1733_730

Díaz-Peromingo J.A., Cortizo-Vidal S., Pardo-Sánchez F., Sánchez-Leira J., García-Suárez M.F., Molinos-Castro S., Pesqueira-Fontán P., Iglesias-Gallego M., Saborido-Froján J., Padín Paz E., Naveiro-Soneira J.

Objective: To study the incidence of Methicillin resistant Staphylococcus aureus (MRSA) infection in a new opened hospital and the impact of a nearby nursing home opening.

Methods: Retrospective analysis of patients infected with MRSA from November 1998 to October 2006. Our hospital covers a population of about 66,000 people and lacks of Intensive Care Unit (ICU). Age, sex, concomitant diseases and mortality were analysed. A nursing home was opened in the hospital influence area (April 2002). We analysed the impact of this in terms of hospital admissions due to MRSA infections. Nasal culture of the nursing home residents was performed to know the prevalence of MRSA carriers.

Results: 64 patients were admitted to the department of Internal Medicine suffering MRSA infections. Blood culture was positive in 10 cases; skin and subcutaneous tissue culture in 7 cases and sputum culture in 47 cases. Middle age was 73 (range 43–91) years old; 45 patients were men and 19 women. During 1998 and 1999 there were no SAMR infections reported. In 2000 (3), 2001 (5), 2002 (3), 2003 (8), 2004 (13), 2005 (20), and 2006 (12) cases. The annual incidence of MRSA infection ranged from 4.54/100,000 (years 2000 and 2002) to 30.30/100,000 habitants (year 2005). The most common associated diseases were chronic obstructive pulmonary disease (COPD, 40 patients), hypertension (22 patients), anaemia (16 patients), hyperlipidaemia (15 patients) and smoking, heart failure and atrial fibrillation (12 patients each). Thirteen patients (20.31%) died. When examined nasal culture, a total of 89 cultures were performed (98% of the total number of residents). From these, 9 were positive for MRSA (carrier prevalence of 10.11%).

Conclusions:

1. There is an increasing rate of MRSA infections in our hospital, especially respiratory infections.

2. The most frequent underlying clinical conditions in our patients are COPD, hypertension, anaemia and hyperlipidaemia. MRSA infection leads to a considerable death rate (20%).

3. The opening of a nursing home in our hospital influence area, probably explains the increasing rate in the following years.

4. The relatively old age of our patients all together with the high rate of MRSA carriers and the probable previous admissions to other hospitals (with ICU) of the nursing home residents, points to the need of eradicating this carriers in order to reduce the rate of hospital infections for MRSA related conditions in our area.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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