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.