Methicillin-Resistant Staphylococcus aureus in Saarland, Germany: The Long-Term Care Facility Study

Area of Science:

• Infection Control and Epidemiology
• Public Health
• Healthcare-Associated Infections

Background:

• Multiresistant organisms, like MRSA, pose significant threats in healthcare settings.
• Effective control interventions require tailoring to specific regions, institution types, and patient risk factors.
• Saarland, Germany, provides a suitable setting to study colonization epidemiology across diverse health and care institutions.

Purpose of the Study:

• To conduct a point prevalence study of MRSA in long-term care facilities (LTCFs) in Saarland.
• To compare MRSA prevalence and associated risk factors in LTCFs with acute care hospitals within the same region.
• To inform region-tailored MRSA screening policies and preventative measures.

Main Methods:

• A point prevalence study of MRSA was conducted in 65 out of 136 LTCFs in Saarland between September 2013 and July 2014.
• Microbiological specimens and questionnaires were collected from 2,858 LTCF residents.
• Multivariate risk factor analysis was performed to identify independent associations with MRSA carrier status.

Main Results:

• The overall MRSA carrier rate among screened LTCF residents was 4.8% (136/2,858).
• Independently associated risk factors for MRSA carriage included ulcer/deep soft tissue infection, urinary tract catheter use, and a history of MRSA with multiple decolonization cycles.
• MRSA prevalence in LTCFs (4.8%) was higher than in acute care hospitals (2.2%) but comparable to geriatric acute care departments (7.6%).

Conclusions:

• MRSA colonization is prevalent in LTCF residents, even in regions with generally low MRSA prevalence.
• The clonal relatedness of MRSA isolates between LTCFs and acute care facilities suggests interconnectedness.
• Identified risk factors, including multiple decolonization cycles, indicate MRSA colonization risks independent of acute care exposure, necessitating adapted screening and prevention strategies.