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Prevalence of methicillin-resistant Staphylococcus aureus carriage in Italian long-term care facilities

Abstract number: 1733_1093

Brugnaro P., Mantero J., Cazzaro R., Fedeli U., Mantoan P., Pellizzer G., Tomasini A., Zoppelletto M., Spolaore P.

Objective: Data on the prevalence of Methicillin-Resistant Staphylococcus aureus (MRSA) carriers in long term care facilities are lacking in Italy, being 11% the prevalence reported in the only available investigation conducted in a single facility. Aim of the study is to determine prevalence and risk factors for MRSA carriage in nursing home residents in Vicenza (North-Eastern Italy).

Methods: Nasal swabs were obtained in late June-early July 2006 from residents of the two largest long term care facilities of the city. Laboratory screening for MRSA was performed by means of the MRSA Select Agar (Bio-Rad) and full antibiotic susceptibility was assessed in MRSA isolates. Demographic and clinical data, dependency, cognitive function, length of stay, current and previous antibiotic treatment, presence of medical devices, previous hospital admission, presence of infection according to Association for Professionals in Infection Control criteria were assessed in each subject on the same day of sample collection. The factors significantly associated to MRSA carriage at univariate analysis were introduced in a multiple logistic regression model, and the corresponding odds ratio (OR) with 95% Confidence Intervals (CI) were estimated.

Results: Out of 570 residents nasal swabs were obtained in 551 subjects (96.7%). Among the latter, 73% were females; the mean age was 83 years (31% of residents being aged 90 or more). 118 residents (21%) had at least one hospital admission in the previous year. 63% of subjects received systemic antibiotic treatments in the previous 12 months: 37% were treated with fluoroquinolones, 26% with cephalosporins. Overall 43 MRSA carriers were detected (7.8%; CI: 5.7–10.4%). All MRSA isolates showed fluoroquinolones resistance. At logistic regression the risk of MRSA carriage was increased in patients with cancer (OR = 6.1; CI: 2.5–15.0), with previous hospitalisation (OR = 2.0; CI: 1.0–4.0), and raised with the number of previous antibiotic treatments, reaching an OR = 3.9 (CI: 1.6–9.1) in those with 3 or more treatments.

Conclusion: To date the present study is the largest Italian survey of MRSA carriage in elderly people outside the hospital setting. The prevalence resulted higher than that reported from nursing homes in other European countries like Germany. Both comorbidities (cancer) and pattern of care (previous hospitalisation and antibiotic treatment) were associated with MRSA carriage.

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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