Städtisches Gesundheitsamt, Braunschweig, Germany.
J Hosp Infect. 2011 Jun;78(2):108-12. doi: 10.1016/j.jhin.2011.02.011. Epub 2011 Apr 8.
Nursing home residents are a population at risk for carrying meticillin-resistant Staphylococcus aureus (MRSA). To better guide infection control and healthcare network initiatives, we investigated the point prevalence and molecular epidemiology of MRSA colonisation among nursing home residents in Brunswick, northern Germany. Among the 32 participating nursing homes of the available 34 in the region, 68% of residents (1827 of 2688) were screened for nasal and/or wound colonisation. A total of 139 residents (7.6%; 95% confidence interval: 6.4-8.8%) were identified as MRSA positive, almost six-fold more than the 24 MRSA carriers (0.9%) expected according to the nursing homes' pre-test information. Although known risk factors including urinary tract catheters, wounds, preceding hospital admission, and high grade resident care were confirmed, none was sensitive enough to be considered as the sole determinant of MRSA carriage. spa typing revealed that more than 70% of isolates belonged to the Barnim strain (ST-22, EMRSA-15, CC22) typical for hospital-acquired MRSA in northern Germany. There was no evidence for the presence of community-acquired or livestock-associated S. aureus strains. These data show that in northern Germany MRSA has spread from the hospital environment to other healthcare institutions, which must now be regarded as important reservoirs for MRSA transmission.
养老院居民是携带耐甲氧西林金黄色葡萄球菌（MRSA）的高风险人群。为了更好地指导感染控制和医疗保健网络的工作，我们对德国北部不莱梅地区养老院居民的 MRSA 定植情况进行了现患率调查和分子流行病学研究。在该地区 34 家养老院中，有 32 家参与了调查，68%（1827/2688）的居民接受了鼻腔和/或伤口定植筛查。共有 139 名居民（7.6%；95%置信区间：6.4-8.8%）被确定为 MRSA 阳性，比根据养老院预测试信息预计的 24 名 MRSA 携带者（0.9%）多近 6 倍。虽然确认了包括导尿管、伤口、入院前史和高等级居民护理等已知的危险因素，但没有一个因素足够敏感，可以被认为是 MRSA 定植的唯一决定因素。spa 分型显示，超过 70%的分离株属于 Barnim 株（ST-22、EMRSA-15、CC22），这是德国北部医院获得性 MRSA 的典型菌株。没有证据表明存在社区获得性或与牲畜相关的金黄色葡萄球菌菌株。这些数据表明，在德国北部，MRSA 已经从医院环境传播到其他医疗机构，现在必须将这些机构视为 MRSA 传播的重要储存库。
