Transmission of methicillin-resistant staphylococcus aureus in the long term care facilities in Hong Kong

Vincent C.C. Cheng; Josepha W.M. Tai; Zoie S.Y. Wong; Jonathan H.K. Chen; Kris B.Q. Pan; Yizchen Hai; Wing-Chun Ng; Denise M.K. Chow; Miranda C.Y. Yau; Jasper F.W. Chan; Sally C.Y. Wong; Herman Tse; Sophia S.C. Chan; Kwok-Leung Tsui; Felix H.W. Chan; Pak-Leung Ho; Kwok-Yung Yuen

doi:10.1186/1471-2334-13-205

Transmission of methicillin-resistant staphylococcus aureus in the long term care facilities in Hong Kong

Vincent C.C. Cheng, Josepha W.M. Tai, Zoie S.Y. Wong, Jonathan H.K. Chen, Kris B.Q. Pan, Yizchen Hai, Wing-Chun Ng, Denise M.K. Chow, Miranda C.Y. Yau, Jasper F.W. Chan, Sally C.Y. Wong, Herman Tse, Sophia S.C. Chan, Kwok-Leung Tsui, Felix H.W. Chan, Pak-Leung Ho, Kwok-Yung Yuen

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Abstract

Background: The relative contribution of long term care facilities (LTCFs) and hospitals in the transmission of methicillin-resistant Staphylococcus aureus (MRSA) is unknown.Methods: Concurrent MRSA screening and spa type analysis was performed in LTCFs and their network hospitals to estimate the rate of MRSA acquisition among residents during their stay in LTCFs and hospitals, by colonization pressure and MRSA transmission calculations.Results: In 40 LTCFs, 436 (21.6%) of 2020 residents were identified as 'MRSA-positive'. The incidence of MRSA transmission per 1000-colonization-days among the residents during their stay in LTCFs and hospitals were 309 and 113 respectively, while the colonization pressure in LTCFs and hospitals were 210 and 185 per 1000-patient-days respectively. MRSA spa type t1081 was the most commonly isolated linage in both LTCF residents (76/121, 62.8%) and hospitalized patients (51/87, 58.6%), while type t4677 was significantly associated with LTCF residents (24/121, 19.8%) compared with hospitalized patients (3/87, 3.4%) (p <0.001). This suggested continuous transmission of MRSA t4677 among LTCF residents. Also, an inverse linear relationship between MRSA prevalence in LTCFs and the average living area per LTCF resident was observed (Pearson correlation -0.443, p = 0.004), with the odds of patients acquiring MRSA reduced by a factor of 0.90 for each 10 square feet increase in living area.Conclusions: Our data suggest that MRSA transmission was more serious in LTCFs than in hospitals. Infection control should be focused on LTCFs in order to reduce the burden of MRSA carriers in healthcare settings. © 2013 Cheng et al.; licensee BioMed Central Ltd.

Original language	English
Article number	205
Journal	BMC Infectious Diseases
Volume	13
Issue number	1
DOIs	https://doi.org/10.1186/1471-2334-13-205
Publication status	Published - 6 May 2013

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This full text is made available under CC-BY 2.0. https://creativecommons.org/licenses/by/2.0/

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Cheng, V. C. C., Tai, J. W. M., Wong, Z. S. Y., Chen, J. H. K., Pan, K. B. Q., Hai, Y., Ng, W.-C., Chow, D. M. K., Yau, M. C. Y., Chan, J. F. W., Wong, S. C. Y., Tse, H., Chan, S. S. C., Tsui, K.-L., Chan, F. H. W., Ho, P.-L., & Yuen, K.-Y. (2013). Transmission of methicillin-resistant staphylococcus aureus in the long term care facilities in Hong Kong. BMC Infectious Diseases, 13(1), Article 205. https://doi.org/10.1186/1471-2334-13-205

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title = "Transmission of methicillin-resistant staphylococcus aureus in the long term care facilities in Hong Kong",

abstract = "Background: The relative contribution of long term care facilities (LTCFs) and hospitals in the transmission of methicillin-resistant Staphylococcus aureus (MRSA) is unknown.Methods: Concurrent MRSA screening and spa type analysis was performed in LTCFs and their network hospitals to estimate the rate of MRSA acquisition among residents during their stay in LTCFs and hospitals, by colonization pressure and MRSA transmission calculations.Results: In 40 LTCFs, 436 (21.6%) of 2020 residents were identified as 'MRSA-positive'. The incidence of MRSA transmission per 1000-colonization-days among the residents during their stay in LTCFs and hospitals were 309 and 113 respectively, while the colonization pressure in LTCFs and hospitals were 210 and 185 per 1000-patient-days respectively. MRSA spa type t1081 was the most commonly isolated linage in both LTCF residents (76/121, 62.8%) and hospitalized patients (51/87, 58.6%), while type t4677 was significantly associated with LTCF residents (24/121, 19.8%) compared with hospitalized patients (3/87, 3.4%) (p <0.001). This suggested continuous transmission of MRSA t4677 among LTCF residents. Also, an inverse linear relationship between MRSA prevalence in LTCFs and the average living area per LTCF resident was observed (Pearson correlation -0.443, p = 0.004), with the odds of patients acquiring MRSA reduced by a factor of 0.90 for each 10 square feet increase in living area.Conclusions: Our data suggest that MRSA transmission was more serious in LTCFs than in hospitals. Infection control should be focused on LTCFs in order to reduce the burden of MRSA carriers in healthcare settings. {\textcopyright} 2013 Cheng et al.; licensee BioMed Central Ltd.",

author = "Cheng, {Vincent C.C.} and Tai, {Josepha W.M.} and Wong, {Zoie S.Y.} and Chen, {Jonathan H.K.} and Pan, {Kris B.Q.} and Yizchen Hai and Wing-Chun Ng and Chow, {Denise M.K.} and Yau, {Miranda C.Y.} and Chan, {Jasper F.W.} and Wong, {Sally C.Y.} and Herman Tse and Chan, {Sophia S.C.} and Kwok-Leung Tsui and Chan, {Felix H.W.} and Pak-Leung Ho and Kwok-Yung Yuen",

year = "2013",

month = may,

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doi = "10.1186/1471-2334-13-205",

language = "English",

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Cheng, VCC, Tai, JWM, Wong, ZSY, Chen, JHK, Pan, KBQ, Hai, Y, Ng, W-C, Chow, DMK, Yau, MCY, Chan, JFW, Wong, SCY, Tse, H, Chan, SSC, Tsui, K-L, Chan, FHW, Ho, P-L & Yuen, K-Y 2013, 'Transmission of methicillin-resistant staphylococcus aureus in the long term care facilities in Hong Kong', BMC Infectious Diseases, vol. 13, no. 1, 205. https://doi.org/10.1186/1471-2334-13-205

TY - JOUR

T1 - Transmission of methicillin-resistant staphylococcus aureus in the long term care facilities in Hong Kong

AU - Cheng, Vincent C.C.

AU - Tai, Josepha W.M.

AU - Wong, Zoie S.Y.

AU - Chen, Jonathan H.K.

AU - Pan, Kris B.Q.

AU - Hai, Yizchen

AU - Ng, Wing-Chun

AU - Chow, Denise M.K.

AU - Yau, Miranda C.Y.

AU - Chan, Jasper F.W.

AU - Wong, Sally C.Y.

AU - Tse, Herman

AU - Chan, Sophia S.C.

AU - Tsui, Kwok-Leung

AU - Chan, Felix H.W.

AU - Ho, Pak-Leung

AU - Yuen, Kwok-Yung

PY - 2013/5/6

Y1 - 2013/5/6

N2 - Background: The relative contribution of long term care facilities (LTCFs) and hospitals in the transmission of methicillin-resistant Staphylococcus aureus (MRSA) is unknown.Methods: Concurrent MRSA screening and spa type analysis was performed in LTCFs and their network hospitals to estimate the rate of MRSA acquisition among residents during their stay in LTCFs and hospitals, by colonization pressure and MRSA transmission calculations.Results: In 40 LTCFs, 436 (21.6%) of 2020 residents were identified as 'MRSA-positive'. The incidence of MRSA transmission per 1000-colonization-days among the residents during their stay in LTCFs and hospitals were 309 and 113 respectively, while the colonization pressure in LTCFs and hospitals were 210 and 185 per 1000-patient-days respectively. MRSA spa type t1081 was the most commonly isolated linage in both LTCF residents (76/121, 62.8%) and hospitalized patients (51/87, 58.6%), while type t4677 was significantly associated with LTCF residents (24/121, 19.8%) compared with hospitalized patients (3/87, 3.4%) (p <0.001). This suggested continuous transmission of MRSA t4677 among LTCF residents. Also, an inverse linear relationship between MRSA prevalence in LTCFs and the average living area per LTCF resident was observed (Pearson correlation -0.443, p = 0.004), with the odds of patients acquiring MRSA reduced by a factor of 0.90 for each 10 square feet increase in living area.Conclusions: Our data suggest that MRSA transmission was more serious in LTCFs than in hospitals. Infection control should be focused on LTCFs in order to reduce the burden of MRSA carriers in healthcare settings. © 2013 Cheng et al.; licensee BioMed Central Ltd.

AB - Background: The relative contribution of long term care facilities (LTCFs) and hospitals in the transmission of methicillin-resistant Staphylococcus aureus (MRSA) is unknown.Methods: Concurrent MRSA screening and spa type analysis was performed in LTCFs and their network hospitals to estimate the rate of MRSA acquisition among residents during their stay in LTCFs and hospitals, by colonization pressure and MRSA transmission calculations.Results: In 40 LTCFs, 436 (21.6%) of 2020 residents were identified as 'MRSA-positive'. The incidence of MRSA transmission per 1000-colonization-days among the residents during their stay in LTCFs and hospitals were 309 and 113 respectively, while the colonization pressure in LTCFs and hospitals were 210 and 185 per 1000-patient-days respectively. MRSA spa type t1081 was the most commonly isolated linage in both LTCF residents (76/121, 62.8%) and hospitalized patients (51/87, 58.6%), while type t4677 was significantly associated with LTCF residents (24/121, 19.8%) compared with hospitalized patients (3/87, 3.4%) (p <0.001). This suggested continuous transmission of MRSA t4677 among LTCF residents. Also, an inverse linear relationship between MRSA prevalence in LTCFs and the average living area per LTCF resident was observed (Pearson correlation -0.443, p = 0.004), with the odds of patients acquiring MRSA reduced by a factor of 0.90 for each 10 square feet increase in living area.Conclusions: Our data suggest that MRSA transmission was more serious in LTCFs than in hospitals. Infection control should be focused on LTCFs in order to reduce the burden of MRSA carriers in healthcare settings. © 2013 Cheng et al.; licensee BioMed Central Ltd.

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DO - 10.1186/1471-2334-13-205

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Transmission of methicillin-resistant staphylococcus aureus in the long term care facilities in Hong Kong

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