While most infection control measures are focused on hospitals, a new study points to the need for more targeted interventions to prevent the spread of drug-resistant bugs in nursing homes as community-associated strains of methicillin-resistant Staphylococcus aureus (CA-MRSA) are on the rise in these facilities. The study is published in the March issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.
CA-MRSA is a growing cause of invasive disease, including bloodstream infections, abscesses, and pneumonia. The prevalence of CA-MRSA in nursing homes has not been well characterized compared with that in hospitals. Since most nursing home residents are admitted directly from hospitals, importation of CA-MRSA may increase in nursing homes as CA-MRSA increases in hospitals. Nursing home residents also have increased risk factors for MRSA, including diabetes, long-term use of indwelling devices, and inability to perform activities of daily living.
Researchers at the University of California, Irvine assessed the frequency of CA-MRSA carriage among residents in a convenience sample of 22 of the 72 nursing homes in Orange County, California, during the period October 2008-May 2011. Strains were found by swabbing the noses of 100 residents in each nursing home at a single visit and up to another 100 additional swabs from newly admitted residents.
Of the MRSA-positive swabs, 25 percent (208/824) were positive for CA-MRSA. The study also found CA-MRSA was present in 20 out of 22 nursing homes tested.
"Community-type strains first arose among healthy community members without exposure to the healthcare system and have steadily infiltrated many hospitals," said Courtney R. Murphy, PhD, the study's lead researcher. "We believe these at-risk facilities could benefit from further infection control interventions, such as enhanced environmental cleaning or skin decolonization."