Transmission of methicillin-resistant Staphylococcus aureus in the long term care facilities in Hong Kong
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Updated: May 11, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Vincent C C Cheng1, Josepha W M Tai, Zoie S Y Wong
1Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
Background:
The relative contribution of long term care facilities (LTCFs) and hospitals in the transmission of methicillin-resistant Staphylococcus aureus (MRSA) is unknown.
Methods:
Concurrent MRSA screening and spa type analysis was performed in LTCFs and their network hospitals to estimate the rate of MRSA acquisition among residents during their stay in LTCFs and hospitals, by colonization pressure and MRSA transmission calculations.
Results:
In 40 LTCFs, 436 (21.6%) of 2020 residents were identified as 'MRSA-positive'. The incidence of MRSA transmission per 1000-colonization-days among the residents during their stay in LTCFs and hospitals were 309 and 113 respectively, while the colonization pressure in LTCFs and hospitals were 210 and 185 per 1000-patient-days respectively. MRSA spa type t1081 was the most commonly isolated linage in both LTCF residents (76/121, 62.8%) and hospitalized patients (51/87, 58.6%), while type t4677 was significantly associated with LTCF residents (24/121, 19.8%) compared with hospitalized patients (3/87, 3.4%) (p<0.001). This suggested continuous transmission of MRSA t4677 among LTCF residents. Also, an inverse linear relationship between MRSA prevalence in LTCFs and the average living area per LTCF resident was observed (Pearson correlation -0.443, p=0.004), with the odds of patients acquiring MRSA reduced by a factor of 0.90 for each 10 square feet increase in living area.
Conclusions:
Our data suggest that MRSA transmission was more serious in LTCFs than in hospitals. Infection control should be focused on LTCFs in order to reduce the burden of MRSA carriers in healthcare settings.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) transmission is higher in long-term care facilities (LTCFs) than hospitals. Focusing infection control on LTCFs can reduce MRSA carriers in healthcare settings.
Area of Science:
- Infectious Disease Epidemiology
- Healthcare-Associated Infections
- Microbiology
Background:
- The relative contribution of long-term care facilities (LTCFs) and hospitals to methicillin-resistant Staphylococcus aureus (MRSA) transmission remains unclear.
- Understanding transmission dynamics is crucial for effective infection control strategies.
Purpose of the Study:
- To compare the rates of MRSA acquisition and transmission between LTCFs and their affiliated hospitals.
- To identify factors influencing MRSA spread within these settings.
Main Methods:
- Concurrent MRSA screening and spa typing were conducted in LTCFs and network hospitals.
- MRSA acquisition rates were estimated using colonization pressure and transmission calculations.
- Spa types were analyzed to track MRSA lineages and their associations with different healthcare settings.
Main Results:
- MRSA prevalence was 21.6% among 2020 residents in 40 LTCFs.
- MRSA transmission incidence was higher in LTCFs (309 per 1000-colonization-days) compared to hospitals (113 per 1000-colonization-days).
- MRSA spa type t4677 was significantly associated with LTCF residents, indicating continuous transmission within these facilities. Increased living area per resident was linked to reduced MRSA acquisition odds.
Conclusions:
- MRSA transmission poses a more significant challenge in LTCFs than in hospitals.
- Infection control efforts should prioritize LTCFs to mitigate the burden of MRSA.
- Optimizing living space in LTCFs may help reduce MRSA transmission.
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