Primary Care Unit, Health Protection Agency, Gloucestershire, UK.
Epidemiol Infect. 2010 May;138(5):686-96. doi: 10.1017/S0950268810000233. Epub 2010 Feb 11.
The aim of this study was to investigate the prevalence and associated risk factors of methicillin-susceptible and methicillin-resistant Staphylocccus aureus (MSSA and MRSA) carriage in care homes, with particular focus on dementia. A point-prevalence survey of 748 residents in 51 care homes in Gloucestershire and Greater Bristol was undertaken. Dementia was assessed by the clock test or abbreviated mini-mental test. Nasal swabs were cultured for S. aureus on selective agar media. Multivariable analysis indicated that dementia was not a significant risk factor for MSSA (16.2%) or MRSA (7.8%); and that residents able to move around the home unassisted were at a lower risk of MRSA (P=0.04). MSSA carriage increased with increasing age (P=0.03) but MRSA carriage decreased with increasing age (P=0.05). Hospitalization in the last 6 months increased the risk of MSSA (P=0.04) and MRSA (P=0.10). We concluded that cross-infection through staff caring for more dependent residents may spread MRSA within care homes and from the recently hospitalized. Control of MSSA and MRSA in care homes requires focused infection control interventions.
本研究旨在调查养老院中耐甲氧西林金黄色葡萄球菌（MSSA 和 MRSA）携带的流行情况及其相关危险因素，特别关注痴呆症。在格洛斯特郡和大布里斯托尔的 51 家养老院中对 748 名居民进行了点患病率调查。通过时钟测试或简化的迷你精神状态测试评估痴呆症。鼻拭子在选择性琼脂培养基上培养金黄色葡萄球菌。多变量分析表明，痴呆症不是 MSSA（16.2%）或 MRSA（7.8%）的重要危险因素；能够在家庭中自由走动的居民感染 MRSA 的风险较低（P=0.04）。MSSA 携带率随年龄增长而增加（P=0.03），但 MRSA 携带率随年龄增长而降低（P=0.05）。最近 6 个月住院会增加 MSSA（P=0.04）和 MRSA（P=0.10）的风险。我们的结论是，员工照顾依赖性更高的居民可能会导致 MRSA 在养老院中传播，并从最近住院的患者中传播。需要针对 MSSA 和 MRSA 进行感染控制干预，以控制养老院中的感染。
