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Patients in bedbound, rehabilitation unit in long-term care facilities may have increased MRSA risk
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Bedbound patients and rehabilitation unit residents were at a statistically significant risk for methicillin-resistant Staphylococcus aureus in eight long-term care facilities in Maryland.
These findings were presented by John Furuno, PhD, of the University of Maryland School of Medicine.
“We collected surveillance cultures from anterior nares and from the largest area of skin breakdown at enrollment and at study weeks four, eight and 12, then again at discharge,” Furuno said. “We defined acquisition as subsequent positive culture following negative enrollment culture.”
Risk factors for MRSA among 536 admitted patients were analyzed. There were 39 infections.
Bivariate analysis demonstrated that residence in a rehabilitation unit, as opposed to a residential unit, yielded an HR of 5.5 (95% CI; 2.9, 10.7); being bedbound yielded an HR of 4.1 (95% CI; 2.0, 8.3) and skin breakdown yielded an HR of 2.3 (95% CI; 1.2, 4.4).
Associations between being bedbound and residence in a rehabilitation unit remained in multivariate analyses.
“These data support the hypothesis that healthcare workers continue to be vectors for transmission,” Furuno said.
Furuno J. #506. Presented at SHEA 2009 Annual Scientific Meeting. March 19-March 22, 2009. San Diego.