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Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) among residents of nursing homes in Belgium.
J Antimicrob Chemother 2009; 64(6):1299-306JA

Abstract

OBJECTIVES

A national survey was conducted to determine the prevalence, risk factors and molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) carriage among nursing home (NH) residents in Belgium.

METHODS

A random stratified, cross-sectional prevalence survey was conducted in NH residents who were screened for MRSA carriage by multisite enriched culture. Characteristics of NHs and residents were collected by a questionnaire survey and analysed by two-stage logistic regression modelling. MRSA isolates were genotyped by PFGE, staphylococcal cassette chromosome mec (SCCmec) typing, multilocus sequence typing (MLST) and resistance genes.

RESULTS

Of 2953 residents screened in 60 NHs, 587 (19.9%) were MRSA carriers. Risk factors included hospital contact, antibiotic exposure, impaired mobility and skin lesions at the resident level, and lack of MRSA surveillance, lack of antibiotic therapeutic formulary and the combination of less-developed infection control activities and a high ratio of physicians to residents at the institution level. MRSA isolates showed eight major types, three of which were predominant: B2-ST45-SCCmec IV (49%; where ST stands for sequence type); A21-ST8-SCCmec IV (13%); and A20-ST8-SCCmec IV (10%). Each was recovered in 55, 21 and 25 NHs, respectively. The geographical distribution of NH genotypes paralleled that of acute-care hospitals.

CONCLUSIONS

A high prevalence of MRSA carriage in NH residents was associated with hospital care, co-morbidities and less-developed coordination of institutional care. The predominant MRSA strains from NH residents and hospitalized patients of the same area were identical. Strengthening and coordination of MRSA surveillance and control activities are warranted within and between NHs and hospitals.

Authors+Show Affiliations

Laboratoire de Référence MRSA-Staphylocoques, Department of Microbiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium. odenis@ulb.ac.beNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19808236

Citation

Denis, Olivier, et al. "Epidemiology of Methicillin-resistant Staphylococcus Aureus (MRSA) Among Residents of Nursing Homes in Belgium." The Journal of Antimicrobial Chemotherapy, vol. 64, no. 6, 2009, pp. 1299-306.
Denis O, Jans B, Deplano A, et al. Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) among residents of nursing homes in Belgium. J Antimicrob Chemother. 2009;64(6):1299-306.
Denis, O., Jans, B., Deplano, A., Nonhoff, C., De Ryck, R., Suetens, C., & Struelens, M. J. (2009). Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) among residents of nursing homes in Belgium. The Journal of Antimicrobial Chemotherapy, 64(6), pp. 1299-306. doi:10.1093/jac/dkp345.
Denis O, et al. Epidemiology of Methicillin-resistant Staphylococcus Aureus (MRSA) Among Residents of Nursing Homes in Belgium. J Antimicrob Chemother. 2009;64(6):1299-306. PubMed PMID: 19808236.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) among residents of nursing homes in Belgium. AU - Denis,Olivier, AU - Jans,Bea, AU - Deplano,Ariane, AU - Nonhoff,Claire, AU - De Ryck,Raf, AU - Suetens,Carl, AU - Struelens,Marc J, Y1 - 2009/09/24/ PY - 2009/10/8/entrez PY - 2009/10/8/pubmed PY - 2010/2/13/medline SP - 1299 EP - 306 JF - The Journal of antimicrobial chemotherapy JO - J. Antimicrob. Chemother. VL - 64 IS - 6 N2 - OBJECTIVES: A national survey was conducted to determine the prevalence, risk factors and molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) carriage among nursing home (NH) residents in Belgium. METHODS: A random stratified, cross-sectional prevalence survey was conducted in NH residents who were screened for MRSA carriage by multisite enriched culture. Characteristics of NHs and residents were collected by a questionnaire survey and analysed by two-stage logistic regression modelling. MRSA isolates were genotyped by PFGE, staphylococcal cassette chromosome mec (SCCmec) typing, multilocus sequence typing (MLST) and resistance genes. RESULTS: Of 2953 residents screened in 60 NHs, 587 (19.9%) were MRSA carriers. Risk factors included hospital contact, antibiotic exposure, impaired mobility and skin lesions at the resident level, and lack of MRSA surveillance, lack of antibiotic therapeutic formulary and the combination of less-developed infection control activities and a high ratio of physicians to residents at the institution level. MRSA isolates showed eight major types, three of which were predominant: B2-ST45-SCCmec IV (49%; where ST stands for sequence type); A21-ST8-SCCmec IV (13%); and A20-ST8-SCCmec IV (10%). Each was recovered in 55, 21 and 25 NHs, respectively. The geographical distribution of NH genotypes paralleled that of acute-care hospitals. CONCLUSIONS: A high prevalence of MRSA carriage in NH residents was associated with hospital care, co-morbidities and less-developed coordination of institutional care. The predominant MRSA strains from NH residents and hospitalized patients of the same area were identical. Strengthening and coordination of MRSA surveillance and control activities are warranted within and between NHs and hospitals. SN - 1460-2091 UR - https://www.unboundmedicine.com/medline/citation/19808236/Epidemiology_of_methicillin_resistant_Staphylococcus_aureus__MRSA__among_residents_of_nursing_homes_in_Belgium_ L2 - https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkp345 DB - PRIME DP - Unbound Medicine ER -