Methicillin-resistant Staphylococcus aureus in elderly care facilities

Abstract

Among multidrug-resistant bacteria, methicillin-resistant Staphylococcus aureus (MRSA) is of immediate concern, given its potential for pathogenicity and widespread presence in geriatric hospitals. Epidemiological surveys indicate that rates of MRSA cross-transmission are increasing in elderly care facilities. MRSA carriage is far more frequent than MRSA-positive clinical specimens in this setting, and the consequences of these epidemics in terms of morbidity, remain limited within these facilities. However, given that patients are continually transferred between long-term and acute-care facilities, it is reasonable to consider these units together with all other care units and to measure the effect of MRSA on a regional healthcare network, rather than on the scale of a given ward or hospital. With regard to the worldwide increase in morbidity associated with MRSA, the emergence of a community-based disease linked to these strains and the emergence of glycopeptide-resistant strains, the application of a voluntary strategy including screening, isolation and eventually, topical decolonization in elderly care facilities, appears to be an urgent matter of priority, even if this strategy will be expensive.