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Updated: Feb 17, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) at a palliative care unit: A prospective single
Maria Heckel1, Walter Geißdörfer2, Franziska A Herbst3
1Department of Palliative Medicine, Comprehensive Cancer Center CCC Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Germany.
Background:
The emergence of multidrug-resistant bacterial microorganisms is a particular challenge for the health care systems. Little is known about the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Gram-negative bacteria (MDRGNB) in patients of palliative care units (PCU).
Aim:
The primary aim of this study was to determine the carriage of MRSA among patients of a PCU at a German University Hospital and to assess whether the positive cases would have been detected by a risk-factor-based screening-approach.
Design:
Between February 2014 and January 2015 patients from our PCU were tested for MRSA carriage within 48 hours following admission irrespective of pre-existing risk factors. In addition, risk factors for MRSA colonization were assessed. Samples from the nostrils and, if applicable, from pre-existing wounds were analysed by standardized culture-based laboratory techniques for the presence of MRSA and of other bacteria and fungi. Results from swabs taken prior to admission were also recorded if available.
Results:
297 out of 317 patients (93.7%) fulfilled one or more MRSA screening criteria. Swabs from 299 patients were tested. The detection rate was 2.1% for MRSA. All MRSA cases would have been detected by a risk-factor-based screening-approach. Considering the detected cases and the results from swabs taken prior to admission, 4.1% of the patients (n = 13) were diagnosed with MRSA and 4.1% with MDRGNB (n = 13), including two patients with MRSA and MDRGNB (0.6%). The rate of MRSA carriage in PCU patients (4.1%) was elevated compared to the rate seen in the general cohort of patients admitted to our University Hospital (2.7%).
Conclusions:
PCU patients have an increased risk to carry MRSA compared to other hospitalized patients. Although a risk factor-based screening is likely to detect all MRSA carriers amongst PCU patients, we rather recommend a universal screening to avoid the extra effort to identify the few risk factor-negative patients (<7%). As we did not perform a systematic MDRGNB screening, further studies are needed to determine the true prevalence of MDRGNB amongst PCU patients.
Insights
Palliative care patients show a higher carriage rate of methicillin-resistant Staphylococcus aureus (MRSA) than general hospital patients. Universal screening is recommended for MRSA in palliative care units (PCUs) to ensure early detection.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Hospital Epidemiology
Background:
- Multidrug-resistant organisms (MDROs) pose a significant healthcare challenge.
- Limited data exists on methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Gram-negative bacteria (MDRGNB) carriage in palliative care units (PCUs).
Purpose of the Study:
- To determine MRSA carriage rates in PCU patients at a German University Hospital.
- To evaluate the effectiveness of risk-factor-based screening for MRSA detection in PCU patients.
Main Methods:
- Prospective screening of PCU patients for MRSA within 48 hours of admission (February 2014-January 2015).
- Analysis of nasal swabs and wound samples using standardized culture techniques.
- Recording of pre-existing risk factors and prior admission swab results.
Main Results:
- MRSA was detected in 4.1% of PCU patients, a higher rate than the hospital's general patient cohort (2.7%).
- All MRSA cases would have been identified by a risk-factor-based screening approach.
- A prevalence of 4.1% for MDRGNB was also observed, with 0.6% co-colonization of MRSA and MDRGNB.
Conclusions:
- PCU patients exhibit an elevated risk of MRSA carriage compared to other hospitalized individuals.
- Universal MRSA screening in PCUs is recommended over risk-factor-based screening to capture all carriers efficiently.
- Further research is necessary to ascertain the prevalence of MDRGNB in PCU populations.
