scholarly journals Clinical significance of methicillin-resistantStaphylococcus aureuscolonization in residents in community long-term-care facilities in Spain

2011 ◽  
Vol 140 (3) ◽  
pp. 400-406 ◽  
Author(s):  
A. MANZUR ◽  
E. RUIZ DE GOPEGUI ◽  
M. DOMINGUEZ ◽  
D. MARISCAL ◽  
L. GAVALDA ◽  
...  
Keyword(s):  
Long Term Care ◽  
Respiratory Infections ◽  
Decubitus Ulcer ◽  
Term Care ◽  
Care Facilities ◽  
Mrsa Infection ◽  
Epidemiological Impact ◽  
Mrsa Colonization ◽  
Overall Mortality

SUMMARYMethicillin-resistantStaphylococcus aureus(MRSA) is highly prevalent in Spanish hospitals and community long-term-care facilities (LTCFs). This longitudinal study was performed in community LTCFs to determine whether MRSA colonization is associated with MRSA infections and overall mortality. Nasal and decubitus ulcer cultures were performed every 6 months for an 18-month period on 178 MRSA-colonized residents (86 490 patient-days) and 196 non-MRSA carriers (97 470 patient-days). Fourteen residents developed MRSA infections and 10 of these were skin and soft tissue infections. Two patients with respiratory infections required hospitalization. The incidence rate of MRSA infection was 0·12/1000 patient-days in MRSA carriers and 0·05/1000 patient-days in non-carriers (P=0·46). No difference in MRSA infection rate was found according to the duration of MRSA colonization (P=0·69). The mortality rate was 20·8% in colonized residents and 16·8% in non-carriers; four residents with MRSA infection died. Overall mortality was statistically similar in both cohorts. Our results suggest that despite a high prevalence of MRSA colonization in LTCFs, MRSA infections are neither frequent nor severe while colonized residents remain at the facility. The epidemiological impact of an MRSA reservoir is more relevant than the clinical impact of this colonization for an individual resident and supports current recommendations to control MRSA spread in community LTCFs.

USA300 methicillin-resistant S. aureus (USA300 MRSA) colonization and the risk of MRSA infection in residents of extended-care facilities

2011 ◽  
Vol 140 (3) ◽  
pp. 390-399 ◽  
Author(s):  
S. M. SHURLAND ◽  
O. C. STINE ◽  
R. A. VENEZIA ◽  
M. ZHAN ◽  
J. P. FURUNO ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Long Term Care ◽  
Risk Of Infection ◽  
Term Care ◽  
Extended Care ◽  
Care Facilities ◽  
Mrsa Infection ◽  
Mrsa Colonization

SUMMARYTo examine the pathogenesis of USA300 MRSA infection in long-term care residents, we performed a retrospective cohort study of 1691 adult residents of two extended-care facilities from 2003 to 2007 to assess whether the risk of subsequent MRSA infection is higher in USA300 MRSA-colonized residents compared to non-colonized residents or non-USA300 MRSA colonized residents. Six per cent of residents were colonized with USA300 MRSA; 12% of residents were colonized with non-USA300 MRSA; and 101 residents developed MRSA infection. The risk of infection was twofold higher in residents colonized with USA300 MRSA compared to residents not colonized with MRSA [adjusted hazard ratio 2·3, 95% confidence interval (CI) 1·1–4·5]. The risk of infection in USA300 MRSA-colonized residents was similar to USA300 MRSA non-colonized residents (relative risk 1·1, 95% CI 0·5–2·3). Our findings show that colonization with USA300 MRSA increases the risk of MRSA infection suggesting a similar pathogenesis.

scholarly journals Association Between Length of Residence and Prevalence of Mrsa Colonization Among Residents in Geriatric Long-term Care Facilities

2020 ◽  
Author(s):  
Teppei Sasahara ◽  
Ryusuke Ae ◽  
Akio Yoshimura ◽  
Koki Kosami ◽  
Kazumasa Sasaki ◽  
...  
Keyword(s):  
Long Term Care ◽  
Length Of Residence ◽  
Term Care ◽  
Initial Testing ◽  
High Prevalence ◽  
Care Facilities ◽  
Cross Transmission ◽  
Mrsa Colonization ◽  
Geriatric Long Term Care

Abstract Background: A high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization has been reported among residents in geriatric long-term care facilities (LTCFs). Some studies indicate that MRSA might be imported from hospitals into LTCFs via resident transfer; however, other studies report that high MRSA prevalence might be caused by cross-transmission inside LTCFs. We aimed to assess which factors have a large impact on the high MRSA prevalence among residents of geriatric LTCFs.Methods: We conducted a cohort study among 260 residents of four geriatric LTCFs in Japan. Dividing participants into two cohorts, we separately analyzed (1) the association between prevalence of MRSA carriage and length of LTCF residence (Cohort 1: n=204), and (2) proportion of residents identified as MRSA negative who were initially tested at admission but subsequently identified as positive in secondary testing performed at ≥2 months after their initial test (Cohort 2: n=79).Results: Among 204 residents in Cohort 1, 20 (9.8%) were identified as positive for MRSA. Compared with residents identified as MRSA negative, a larger proportion of MRSA-positive residents had shorter periods of residence from the initial admission (median length of residence: 5.5 vs. 2.8 months), although this difference was not statistically significant (p=0.084). Among 79 residents in Cohort 2, 60 (75.9%) were identified as MRSA negative at the initial testing. Of these 60 residents, only one (1.7%) had subsequent positive conversion in secondary MRSA testing. In contrast, among 19 residents identified as MRSA positive in the initial testing, 10 (52.6%) were negative in secondary testing.Conclusions: The prevalence of MRSA was lower among residents with longer periods of LTCF residence than among those with shorter periods. Furthermore, few residents were found to become MRSA carrier after their initial admission. These findings highlight that MRSA in LTCFs is most likely to be associated with resident transfer rather than spread via cross-transmission inside LTCFs.

Transmission Clusters of Methicillin-Resistant Staphylococcus Aureus in Long-Term Care Facilities Based on Whole-Genome Sequencing

2016 ◽  
Vol 37 (6) ◽  
pp. 685-691 ◽  
Author(s):  
O. Colin Stine ◽  
Shana Burrowes ◽  
Sophia David ◽  
J. Kristie Johnson ◽  
Mary-Claire Roghmann
Keyword(s):  
Staphylococcus Aureus ◽  
Genome Sequencing ◽  
Long Term Care ◽  
Care Facility ◽  
Whole Genome ◽  
Term Care ◽  
Long Term Care Facility ◽  
Care Facilities ◽  
Mrsa Colonization

OBJECTIVETo define how often methicillin-resistant Staphylococcus aureus (MRSA) is spread from resident to resident in long-term care facilities using whole-genome sequencingDESIGNProspective cohort studySETTINGA long-term care facilityPARTICIPANTSElderly residents in a long-term care facilityMETHODSCultures for MRSA were obtained weekly from multiple body sites from residents with known MRSA colonization over 12-week study periods. Simultaneously, cultures to detect MRSA acquisition were obtained weekly from 2 body sites in residents without known MRSA colonization. During the first 12-week cycle on a single unit, we sequenced 8 MRSA isolates per swab for 2 body sites from each of 6 residents. During the second 12-week cycle, we sequenced 30 MRSA isolates from 13 residents with known MRSA colonization and 3 residents who had acquired MRSA colonization.RESULTSMRSA isolates from the same swab showed little genetic variation between isolates with the exception of isolates from wounds. The genetic variation of isolates between body sites on an individual was greater than that within a single body site with the exception of 1 sample, which had 2 unrelated strains among the 8 isolates. In the second cycle, 10 of 16 residents colonized with MRSA (63%) shared 1 of 3 closely related strains. Of the 3 residents with newly acquired MRSA, 2 residents harbored isolates that were members of these clusters.CONCLUSIONSPoint prevalence surveys with whole-genome sequencing of MRSA isolates may detect resident-to-resident transmission more accurately than routine surveillance cultures for MRSA in long-term care facilities.Infect Control Hosp Epidemiol 2016;37:685–691

scholarly journals Surveillance of Respiratory Viruses in Long Term Care Facilities

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Mary Checivich ◽  
Shari Barlow ◽  
Peter Shult ◽  
Erik Residorf ◽  
Jonathan L. Temte
Keyword(s):  
Influenza A ◽  
Nasal Swab ◽  
Long Term Care ◽  
Respiratory Infections ◽  
Respiratory Viruses ◽  
Influenza B ◽  
Rt Pcr ◽  
Term Care ◽  
Care Facilities

ObjectiveTo assess the feasibility of conducting respiratory virus surveillance for residents of long term care facilities (LTCF) using simple nasal swab specimens and to describe the virology of acute respiratory infections (ARI) in LCTFs.IntroductionAlthough residents of LTCFs have high morbidity and mortality associated with ARIs, there is very limited information on the virology of ARI in LTCFs.[1,2] Moreover, most virological testing of LCTF residents is reactive and is triggered by a resident meeting selected surveillance criteria. We report on incidental findings from a prospective trial of introducing rapid influenza diagnostic testing (RIDT) in ten Wisconsin LTCFs over a two-year period with an approach of testing any resident with ARI.MethodsAny resident with new onset of respiratory symptoms consistent with ARI had a nasal swab specimen collected for RIDT by nursing staff. Following processing for RIDT (Quidel Sofia Influenza A+B FIA), the residual swab was placed into viral transport medium and forwarded to the Wisconsin State Laboratory of Hygiene and tested for influenza using RT-PCR (IVD CDC Human Influenza Virus Real-Time RT-PCR Diagnostic Panel), and for 17 viruses (Luminex NxTAG Respiratory Pathogen Panel [RPP]). The numbers of viruses in each of 7 categories [influenza A (FluA ), influenza B (FluB), coronaviruses (COR), human metapneumovirus (hMPV), parainfluenza (PARA), respiratory syncytial virus (RSV) and rhinovirus/enterovirus (R/E)], across the two years were compared using chi-square.ResultsTotals of 164 and 190 specimens were submitted during 2016-2017 and 2017-2018, respectively. RPP identified viruses in 56.2% of specimens, with no difference in capture rate between years (55.5% vs. 56.8%). Influenza A (21.5%), influenza B (16.5%), RSV (19.0%) and hMPV (16.5%) accounted for 73.5% of all detections, while coronaviruses (15.5%), rhino/enteroviruses (8.5%) and parainfluenza (2.5%) were less common. Specific distribution of viruses varied significantly across the two years (Table: X2=48.1, df=6; p<0.001).ConclusionsSurveillance in LTCFs using nasal swabs collected for RIDT is highly feasible and yields virus identification rates similar to those obtained in clinical surveillance of ARI with collection of nasopharyngeal specimens by clinicians and those obtained in a school-based surveillance project of ARI with collection of combined nasal and oropharyngeal specimens collected by trained research assistants. Significant differences in virus composition occurred across the two study years. RSV varied little between years while hMPV demonstrated wide variation. Simple approaches to surveillance may provide a more comprehensive assessment of respiratory viruses in LTCF settings.References(1) Uršič T, Gorišek Miksić N, Lusa L, Strle F, Petrovec M. Viral respiratory infections in a nursing home: a six-month prospective study. BMC Infect Dis. 2016; 16: 637. Published online 2016 Nov 4. doi: 10.1186/s12879-016-1962-8(2) Masse S, Capai L, Falchi A. Epidemiology of Respiratory Pathogens among Elderly Nursing Home Residents with Acute Respiratory Infections in Corsica, France, 2013–2017. Biomed Res Int. 2017; 2017: 1423718. Published online 2017 Dec 17. doi: 10.1155/2017/1423718

scholarly journals Vitamin D Supplementation for the Prevention and/or Treatment of Cardiovascular Disease, Cancer, and Other Conditions in Residents of Long-Term Care Facilities

2021 ◽  
Vol 1 (7) ◽  
Author(s):  
Keeley Farrell ◽  
Jennifer Horton
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Older Adults ◽  
Vitamin D ◽  
Long Term Care ◽  
Respiratory Infections ◽  
Vitamin D Supplementation ◽  
Term Care ◽  
Care Facilities

The results of 1 systematic review suggest that supplementation with vitamin D may provide some benefit for cancer-related mortality in older adults. It is unclear whether there is a benefit of vitamin D supplementation for all-cause mortality; however, no benefit was found for cardiovascular disease mortality, cardiovascular disease events, or cancer incidence. There is limited and mixed evidence on the effectiveness of vitamin D supplementation for dementia and mild cognitive impairment in older adults. The results of 1 systematic review suggest that vitamin D supplementation may provide protection against acute respiratory infections in the overall population; however, this result was not significant in the subgroup of patients older than 65 years. No evidence-based guidelines were identified regarding vitamin D supplementation for the prevention and/or treatment of cardiovascular disease, cancer, and other conditions in elderly patients residing in long-term care facilities.

scholarly journals Fluoroquinolone Impact on Nasal Methicillin-Resistant and Methicillin-Sensitive Staphylococcus aureus Colonization Durations in Neurologic Long-Term-Care Facilities

2015 ◽  
Vol 59 (12) ◽  
pp. 7621-7628 ◽  
Author(s):  
Clotilde Couderc ◽  
Anne C. M. Thiébaut ◽  
Christine Lawrence ◽  
Coralie Bouchiat ◽  
Jean-Louis Herrmann ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Confidence Interval ◽  
Long Term Care ◽  
Methicillin Resistance ◽  
Term Care ◽  
Content Type ◽  
Resistance Phenotype ◽  
Care Facilities ◽  
Mrsa Colonization

ABSTRACTStaphylococcus aureusnasal carriage is a risk factor for subsequent infection. Estimates of colonization duration vary widely among studies, and factors influencing the time to loss of colonization, especially the impact of antibiotics, remain unclear. We conducted a prospective study on patients naive forS. aureuscolonization in 4 French long-term-care facilities. Data on nasal colonization status and potential factors for loss of colonization were collected weekly. We estimated methicillin-resistantS. aureus(MRSA) and methicillin-sensitiveS. aureus(MSSA) colonization durations using the Kaplan-Meier method and investigated factors for loss of colonization using shared-frailty Cox proportional hazards models. A total of 285S. aureuscolonization episodes were identified in 149 patients. The median time to loss of MRSA or MSSA colonization was 3 weeks (95% confidence interval, 2 to 8 weeks) or 2 weeks (95% confidence interval, 2 to 3 weeks), respectively. In multivariable analyses, the methicillin resistance phenotype was not associated withS. aureuscolonization duration (P= 0.21); the use of fluoroquinolones (hazard ratio, 3.37; 95% confidence interval, 1.31 to 8.71) and having a wound positive for a nonnasal strain (hazard ratio, 2.17; 95% confidence interval, 1.15 to 4.07) were associated with earlier loss of MSSA colonization, while no factor was associated with loss of MRSA colonization. These results suggest that the methicillin resistance phenotype does not influence theS. aureuscolonization duration and that fluoroquinolones are associated with loss of MSSA colonization but not with loss of MRSA colonization.

scholarly journals Association between length of residence and prevalence of MRSA colonization among residents in geriatric long-term care facilities

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Teppei Sasahara ◽  
Ryusuke Ae ◽  
Akio Yoshimura ◽  
Koki Kosami ◽  
Kazumasa Sasaki ◽  
...  
Keyword(s):  
Long Term Care ◽  
Length Of Residence ◽  
Term Care ◽  
Initial Testing ◽  
High Prevalence ◽  
Care Facilities ◽  
Cross Transmission ◽  
Mrsa Colonization ◽  
Geriatric Long Term Care

Abstract Background A high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization has been reported among residents in geriatric long-term care facilities (LTCFs). Some studies indicate that MRSA might be imported from hospitals into LTCFs via resident transfer; however, other studies report that high MRSA prevalence might be caused by cross-transmission inside LTCFs. We aimed to assess which factors have a large impact on the high MRSA prevalence among residents of geriatric LTCFs. Methods We conducted a cohort study among 260 residents of four geriatric LTCFs in Japan. Dividing participants into two cohorts, we separately analyzed (1) the association between prevalence of MRSA carriage and length of LTCF residence (Cohort 1: n = 204), and (2) proportion of residents identified as MRSA negative who were initially tested at admission but subsequently identified as positive in secondary testing performed at ≥2 months after their initial test (Cohort 2: n = 79). Results Among 204 residents in Cohort 1, 20 (9.8%) were identified as positive for MRSA. Compared with residents identified as MRSA negative, a larger proportion of MRSA-positive residents had shorter periods of residence from the initial admission (median length of residence: 5.5 vs. 2.8 months), although this difference was not statistically significant (p = 0.084). Among 79 residents in Cohort 2, 60 (75.9%) were identified as MRSA negative at the initial testing. Of these 60 residents, only one (1.7%) had subsequent positive conversion in secondary MRSA testing. In contrast, among 19 residents identified as MRSA positive in the initial testing, 10 (52.6%) were negative in secondary testing. Conclusions The prevalence of MRSA was lower among residents with longer periods of LTCF residence than among those with shorter periods. Furthermore, few residents were found to become MRSA carrier after their initial admission. These findings highlight that MRSA in LTCFs might be associated with resident transfer rather than spread via cross-transmission inside LTCFs.

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