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Updated: May 17, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Nursing home characteristics associated with methicillin-resistant Staphylococcus aureus (MRSA) Burden and
Courtney R Murphy1, Victor Quan, Diane Kim
1Division of Infectious Diseases and Health Policy Research Institute, University of California-Irvine School of Medicine, Irvine, CA, USA. courtner@uci.edu
Background:
MRSA prevalence in nursing homes often exceeds that in hospitals, but reasons for this are not well understood. We sought to measure MRSA burden in a large number of nursing homes and identify facility characteristics associated with high MRSA burden.
Methods:
We performed nasal swabs of residents from 26 nursing homes to measure MRSA importation and point prevalence, and estimate transmission. Using nursing home administrative data, we identified facility characteristics associated with MRSA point prevalence and estimated transmission risk in multivariate models.
Results:
We obtained 1,649 admission and 2,111 point prevalence swabs. Mean MRSA point prevalence was 24%, significantly higher than mean MRSA admission prevalence, 16%, (paired t-test, p<0.001), with a mean estimated MRSA transmission risk of 16%.In multivariate models, higher MRSA point prevalence was associated with higher admission prevalence (p=0.005) and higher proportions of residents with indwelling devices (p=0.01). Higher estimated MRSA transmission risk was associated with higher proportions of residents with diabetes (p=0.01) and lower levels of social engagement (p=0.03).
Conclusions:
MRSA importation was a strong predictor of MRSA prevalence, but MRSA burden and transmission were also associated with nursing homes caring for more residents with chronic illnesses or indwelling devices. Frequent social interaction among residents appeared to be protective of MRSA transmission, suggesting that residents healthy enough to engage in group activities do not incur substantial risks of MRSA from social contact. Identifying characteristics of nursing homes at risk for high MRSA burden and transmission may allow facilities to tailor infection control policies and interventions to mitigate MRSA spread.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in nursing homes. Higher MRSA burden is linked to more residents with chronic illnesses or devices, while social engagement may reduce transmission.
Area of Science:
- Infectious Diseases
- Epidemiology
- Geriatric Medicine
Background:
- Nursing home MRSA prevalence often exceeds hospital rates, with unclear contributing factors.
- Understanding MRSA burden drivers in nursing homes is critical for infection control.
Purpose of the Study:
- To quantify MRSA burden in a large nursing home cohort.
- To identify facility characteristics associated with high MRSA prevalence and transmission.
Main Methods:
- Nasal swabs from 26 nursing homes assessed MRSA importation and point prevalence.
- Administrative data identified facility characteristics linked to MRSA prevalence.
- Multivariate models estimated MRSA transmission risk.
Main Results:
- Mean MRSA point prevalence was 24%, exceeding admission prevalence (16%).
- Estimated mean MRSA transmission risk was 16%.
- High prevalence correlated with admission prevalence and indwelling devices; high transmission risk linked to diabetes and low social engagement.
Conclusions:
- MRSA importation strongly predicts prevalence.
- Chronic illnesses and indwelling devices increase MRSA burden.
- Social engagement appears protective against MRSA transmission, suggesting targeted interventions can mitigate spread.
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