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Updated: Jun 12, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Profile of methicillin-resistant Staphylococcus aureus among nursing home residents in Hawai'i
Fenfang Li1, Pamela Arnsberger, F DeWolfe Miller
1Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI 96822, USA. fenfang@hawaii.edu
Abstract:
Residing in long-term care facilities has long been identified as a risk factor for methicillin-resistant Staphylococcus aureus (MRSA) carriage and infection. The objective of this study was to describe MRSA epidemiology among residents in skilled nursing and intermediate care facilities (SNF/ICF) in Hawai'i, using a statewide, population-based antimicrobial resistance surveillance system. From 2000 to 2005, proportions of MRSA increased significantly during the 6-year study period, from 35.0% in 2000 to 58.6% in 2005 (p < 0.001). High levels of MRSA resistance to several commonly used antibiotics were observed, e.g., the level of MRSA resistance to clindamycin, ciprofloxacin, and erythromycin was at 77%, 90%, and 89% respectively. Nevertheless, there is a significant difference in the MRSA resistance pattern against certain antimicrobials in different geographic areas. For example, the level of MRSA resistance to trimethoprim-sulfamethoxazole was close to zero in Hawai'i County, but 13% in Kaua'i County. In contrast, the MRSA resistance to tetracycline was 46% in Hawai'i County, but 5% in Kaua'i County. Multi-drug resistant MRSA was well-established among nursing homes in Hawai'i. Regional antibiograms are important in the assistance of empirical therapy.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) carriage and infection are significant risks in long-term care. This study tracked MRSA in Hawai
Area of Science:
- Infectious Diseases
- Public Health Surveillance
- Antimicrobial Resistance
Background:
- Long-term care facilities (LTCFs) are known risk factors for methicillin-resistant Staphylococcus aureus (MRSA) carriage and infection.
- Understanding MRSA epidemiology in these settings is crucial for infection control.
Purpose of the Study:
- To describe the epidemiology of MRSA among residents in skilled nursing and intermediate care facilities (SNF/ICF) in Hawai'i.
- To analyze trends in MRSA prevalence and antimicrobial resistance patterns over time.
Main Methods:
- Utilized a statewide, population-based antimicrobial resistance surveillance system in Hawai'i from 2000 to 2005.
- Monitored MRSA proportions and resistance levels to common antibiotics.
Main Results:
- MRSA proportions significantly increased from 35.0% in 2000 to 58.6% in 2005 (p < 0.001).
- High resistance rates were observed for clindamycin (77%), ciprofloxacin (90%), and erythromycin (89%).
- Significant geographic variations in resistance patterns were noted for trimethoprim-sulfamethoxazole and tetracycline.
Conclusions:
- Multi-drug resistant MRSA is well-established in Hawai'i nursing homes.
- Regional antibiograms are essential for guiding empirical antibiotic therapy in LTCFs.
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