MRSA Prevalence and Risk Factors among Health Personnel and Residents in Nursing Homes in Hamburg, Germany - A Cross-Sectional Study

PLoS One. 2017 Jan 9;12(1):e0169425. doi: 10.1371/journal.pone.0169425. eCollection 2017.

Abstract

Introduction: The increase of multidrug-resistant organisms in hospitals causes problems in nursing homes. Staff in geriatric nursing homes are at greater risk of MRSA colonisation. The aim of the study was to describe the occupational exposure to MRSA among health personnel in geriatric nursing.

Methods: A point prevalence survey was conducted among health personnel and residents of geriatric nursing homes within the greater Hamburg district. Nasal swabs and, where relevant, wound swabs were collected for the screening survey. Risk factors for MRSA colonisation were identified by means of a questionnaire and using the files held on the residents. Where tests on nursing staff were positive, a control swab was taken; when the results were confirmed positive, decolonisation was performed. The responsible general practitioners were notified of positive MRSA findings among residents. A molecular biological examination of the MRSA samples was performed.

Results: A total of 19 institutions participated in the study. Nasal swabs were taken from 759 nursing staff and 422 residents. Prevalence of MRSA was 1.6% among staff and 5.5% among residents. MRSA colonisation among health personnel indicated a correlation with male gender (OR 4.5, 95% CI 1.4-14.1). Among the residents, chronic skin diseases (OR 3.2, 95% CI 1.0-10.3) and indwelling devices (OR 3.2, 95% CI 1.2-8.1) were identified as risk factors. No link between MRSA in residents and in health personnel could be established.

Conclusion: The number of MRSA colonisations among nursing staff and residents of geriatric nursing homes in Hamburg was rather low at 1.6% and 5.5% respectively and equates to the results of other surveys in non-outbreak scenarios.

MeSH terms

  • Carrier State / epidemiology*
  • Cross Infection / epidemiology*
  • Cross-Sectional Studies
  • Female
  • Germany / epidemiology
  • Health Personnel*
  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus* / classification
  • Methicillin-Resistant Staphylococcus aureus* / genetics
  • Nursing Homes*
  • Odds Ratio
  • Prevalence
  • Risk Factors
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology*

Grants and funding

This study was funded by the Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services, Germany, unrestricted fund (URL: https://www.bgw-online.de), and a grant of the German Ministry of Health, grant number IIA5-2512FSB103 (URL: http://www.bmg.bund.de/). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.