Models to predict prevalence and transition dynamics of methicillin-resistant Staphylococcus aureus in community nursing homes - 02/05/16
, Christoper J. Crnich, MD, PhD a, b, c, David F. Anderson, PhD d, Dörte Döpfer, DVM, PhD e, fHighlights |
• | Non-USA300 was predicted to remain the dominant MRSA strain in community nursing homes. At steady-state, 20% (95% CI, 15-25%) of residents were predicted to remain colonized with non-USA300 MRSA and 4% (95% CI, 2-7%) with USA300 MRSA. |
• | Residents who used antibiotics in the previous 3 months were twice more likely to acquire MRSA than those who did not (acquisition rates 0.052 (95% CI, 0.038-0.075) and 0.025 (95% CI, 0.018-0.037), respectively). |
• | Antibiotic stewardship may reduce MRSA colonization in community nursing homes. |
Abstract |
Background |
Recent spread of USA300 methicillin-resistant Staphylococcus aureus (MRSA) to nursing homes has been of particular concern. We sought to predict the ultimate prevalence of USA300 and non-USA300 MRSA and to examine the influence of potential risk factors on MRSA acquisition in community nursing homes.
Methods |
The data were collected during a longitudinal MRSA surveillance study that involved 449 residents in 6 community nursing homes in Wisconsin. The subjects were screened every 3 months for up to 1 year. Markov chain models were employed to predict strain-specific prevalence of MRSA at steady state, and to assess the influence of potential risk factors, including recent hospitalizations, invasive medical devices, and antibiotic exposure on MRSA acquisition rates and average duration of colonization.
Results |
At steady state, 20% (95% confidence interval [CI], 15%-25%) of residents were predicted to remain colonized with non-USA300 and 4% (95% CI, 2%-7%) with USA300 MRSA. Residents who used antibiotics during the previous 3 months were twice more likely to acquire MRSA than those who did not (acquisition rates, 0.052; 95% CI, 0.038-0.075 and 0.025; 95% CI, 0.018-0.037, respectively).
Conclusions |
Non-USA300 was predicted to remain the dominant MRSA strain in community nursing homes. The higher rate of MRSA acquisition among residents with recent antibiotic exposure suggests that antibiotic stewardship may reduce MRSA colonization in this setting.
Le texte complet de cet article est disponible en PDF.Key Words : USA300 MRSA, non-USA300 MRSA, colonization, prevalence, risk factors, acquisition rates
Plan
| Conflicts of Interest: None to report. |
|
| CJC was supported by the Clinical and Translational Science Award program through the National Institutes of Health National Center for Advancing Translational Sciences (grant No. UL1TR000427); the University of Wisconsin School of Medicine and Public Health through the Wisconsin Partnership Program; and a research scholarship from the Association of Subspecialty Professors (ASP)/Infectious Diseases Society of America (IDSA) T. Franklin Williams Program. DFA was supported by the National Science Foundation (NSF) grants DMS-1009275 and DMS-1318832 and Army Research Office grant W911NF-14-1-0401. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. |
Vol 44 - N° 5
P. 507-514 - mai 2016 Retour au numéro
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