Methicillin-resistant Staphylococcus aureus in geriatric patients:: Usefulness of screening in a chronic-care setting

OBJECTIVE: To evaluate the contribution of screening to the detection of cases of methicillin-resistant Staphylococcus aureus (MRSA) in a chronic-care facility. DESIGN: Surveillance and laboratory observational study. METHODS: During a 7-month period, we compared imported and acquired MRSA in a chronic-care center by screening patients for carriage of MRSA on admission and discharge, and by recording all cases of clinical specimens positive for MRSA SETTING: The study was conducted in a 120-bed chronic-care center. This center admits approximately 850 patients per year. Approximately 90% of the patients were elderly and were admitted from other hospitals. RESULTS: Of 519 patients admitted during the study period, 129 were positive for MRSA at some point during their residence, including 60 (11.6%.) with MRSA found within 48 hours of admission and 69 (13.3%; 53% of all positives) with nosocomial MRSA. Of the 519 admissions, 332 (64%) were discharged, of whom 62 (19%) were positive for MRSA. Of these 62, 43 (69%) acquired their MRSA during their stay in the center. CONCLUSIONS: Our study confirms the amplification effect of chronic-care facilities on MRSA propagation. It also shows that screening for MRSA carriage in a chronic-care center facilitates the early identification of a large proportion of patients with MRSA (Infect Control Hosp Epidemiol 2001;22:505-509).