[Predictive factors of acquired methicillin-resistant Staphylococcus aureus in a rehabilitation care unit]

Controlling the diffusion of multiresistant bacteria is a priority in the campaign against nosocomial infections. Geriatric units seem to be reservoirs of methicillin-resistant Staphylococcus aureus (MRSA).

The first objective of this study was to determine if some characteristics identified on admission in a rehabilitation care unit could influence the colonization by the bacterium, and to define the rate of importation and acquired-infections. The second objective was to evaluate the preventive effects of enhanced cleaning with hydro-alcoholic solution, in comparison with our previous study made five years before.

One hundred and eighty-eight patients (mean age, 83.75 ± 7.35 years) were included.

The rates of importation and colonization were respectively of 22.4% and 25.5%. The predictive factors of acquisition were dependence, malnutrition, presence of urinary catheter, and chronic wounds. The comparison with data collected five years earlier showed a reduction of colonization rates from 44 to 25%.

Our study highlights the important role of hand contamination in colonization of the MRSA especially for dependent patients, and shows the importance of hand-hygiene compliance, as well as maintaining autonomy among old patients. The use of hydro-alcoholic solution in association with the reinforcement of hospital hygiene measures led to the decrease of acquired-infection rate.