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Biosensor for Detection of Antibiotic Resistant Staphylococcus Bacteria
Published on: May 8, 2013
Screening for Methicillin-resistant Staphylococcus aureus in a residence home for elderly in Germany
1Cepheid GmbH, Unterlindau 29, 60323 Frankfurt, Germany.
Background:
Since many hospitals report high MRSA colonization rates among elderly patients, and because it has been shown that S. aureus colonization increases with advancing age, there are concerns about the introduction of MRSA into nursing homes by MRSA positive patients discharged from hospital. So far, admission screening and subsequent longitudinal screening in residence homes or screening at time of hospital discharge is not established on a regular base. On the other hand, MRSA is acquired frequently during hospital stay. Therefore, the MRSA status of residents remains unclear at the time of re-admission to the residence home. This study was conducted to evaluate the rate of nasal MRSA carriage among residents and nursing staffs of 2 nursing homes for the elderly, the potential acquisition of MRSA during a hospital stay and the feasibility to perform direct screening tests in nursing homes for elderly.
Methods:
In a study period of 5 months, possibility of active PCR-based screening for MRSA has been tested within 2 residence homes for the elderly, with the obligation to avoid inconvenience to the daily working time and working schedule. Residents and staff members were included in the study and positive test results were confirmed with MRSA culture.
Results:
Feasibility of active on site screening in a residence home for the elderly using a rapid PCR method has been confirmed. 154 of 156 residents participated on baseline testing for all current and new admitted residents. In 9 participating residents with former unknown status, nasal carriage with MRSA was confirmed (5.8%). Among 32 documented and eligible movements between the nursing home and the hospital, MRSA could be confirmed after return to the residence home in 2 cases (6.3%). MRSA could also be detected in 1 of 14 participating nursing staff (7.1%).
Conclusion:
Prevalence of MRSA was in a range that has been observed for nursing homes in Germany in previous studies. Residents can acquire MRSA during a hospital stay so that further spread after re-admission into the nursing home cannot be excluded. This study shows that easy to perform direct screening tests in outpatient facilities for nursing of the elderly are promising tools as part of potential new strategies for transmission and infection control in such facilities. Additional studies are needed to investigate if screening followed by interventional hygiene measures can reduce MRSA transmission and infection in such facilities.
Insights
Nasal methicillin-resistant Staphylococcus aureus (MRSA) carriage was found in 5.8% of nursing home residents and 7.1% of staff. Rapid, on-site screening is feasible and can help control MRSA transmission in elderly care facilities.
Area of Science:
- Infectious Diseases
- Geriatric Medicine
- Public Health
Background:
- High rates of methicillin-resistant Staphylococcus aureus (MRSA) colonization in elderly hospital patients raise concerns about introduction into nursing homes.
- Current screening practices for MRSA in nursing home residents are inconsistent, leading to uncertainty about their infection status upon re-admission.
- MRSA acquisition during hospital stays is common, highlighting the need for effective screening in long-term care facilities.
Purpose of the Study:
- To evaluate the prevalence of nasal MRSA carriage among residents and staff in two nursing homes.
- To assess the potential for MRSA acquisition during hospital stays among nursing home residents.
- To determine the feasibility of implementing direct, rapid MRSA screening tests within nursing homes.
Main Methods:
- A 5-month study involving active, polymerase chain reaction (PCR)-based MRSA screening for residents and staff in two nursing homes.
- Screening procedures were designed to minimize disruption to daily operations.
- Positive PCR results were confirmed using MRSA culture.
Main Results:
- On-site MRSA screening using a rapid PCR method was confirmed as feasible.
- Nasal MRSA carriage was identified in 5.8% of residents (9 out of 154) and 7.1% of nursing staff (1 out of 14).
- MRSA was detected in 6.3% of residents (2 out of 32) returning from hospital stays.
Conclusions:
- The prevalence of MRSA in this nursing home setting aligns with previous German studies.
- Residents can acquire MRSA during hospitalization, posing a risk of transmission upon return to the nursing home.
- Direct, easy-to-perform screening tests in elderly care facilities show promise for MRSA transmission and infection control strategies.
