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Routine Screening for Methicillin-Resistant Staphylococcus Aureus Among Patients Newly Admitted to an Acute Rehabilitation Unit

Published online by Cambridge University Press:  02 January 2015

Farrin A. Manian ,
Diane Senkel ,
Jeanne Zack  and
Lynn Meyer
Farrin A. Manian*
Affiliation:
Department of Infection Control, St. John's Mercy Medical Center, St. Louis, Missouri
Diane Senkel
Affiliation:
Department of Infection Control, St. John's Mercy Medical Center, St. Louis, Missouri
Jeanne Zack
Affiliation:
Department of Infection Control, St. John's Mercy Medical Center, St. Louis, Missouri
Lynn Meyer
Affiliation:
Department of Infection Control, St. John's Mercy Medical Center, St. Louis, Missouri
*
621 S. New Ballas, St. Louis, MO 63141
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Abstract

Background:

Following an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in our acute rehabilitation unit in 1987, all patients except in-house transfers (because of their low prevalence of MRSA colonization) underwent MRSA screening cultures on admission.

Objectives:

To better characterize the current profile of patients with positive MRSA screening cultures at the time of admission to our acute rehabilitation unit, and to determine the relative yield of nares, perianal, and wound screening cultures in this population.

Methods:

Prospective chart review with ongoing active surveillance for infections associated with the acute rehabilitation unit.

Results:

The rate of MRSA isolation from one or more body sites increased significantly from 5% (1987–1988) to 12% (1999–2000) (P = .0009) for newly admitted patients and from 0% to 7% (P < .0001) for in-house transfers. A negative nares culture was highly predictive (98%) of a negative perianal culture. Prior history of MRSA infection or colonization and transfer from outside sources were independently associated with positive MRSA screening cultures.

Conclusion:

The rate of MRSA isolation from screening cultures of newly admitted patients, including in-house transfers, has increased significantly during the past decade in our acute rehabilitation unit. When paired with nares cultures, perianal cultures were of limited value in this patient population.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 9 , September 2002 , pp. 516 - 519
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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