New Study Underscores MRSA Risk in Nursing Homes

Finding a suitable nursing home for an older loved one is an arduous and time-consuming process.  Nursing homes can be the best fit for an elderly family member’s care but fears of elder abuse, medical mistakes, and the recent problem of MRSA infections make the choice even more difficult.   Very difficult.

First, what is MRSA?  MRSA is well known as a deadly problem for hospitalized people with open wounds or those recovering from surgery.  This type of MRSA is known as hospital-acquired MRSA.

A new study from the University of California, Irvine shows that the vast majority of surveyed nursing homes tested positive for the drug-resistant MRSA bacteria.   Researchers surveyed 22 facilities and found 20 to have strains of methicillin-resistant Staphylococcus aureus (MRSA).  MRSA is the bacterial strain that no longer responds to the antibiotics used to treat staph infections.   Once it gets going,  it s a beast of a task to fight it off.  What we now know – and suspected all along – is that nursing home patients are particularly at risk, even more so than others patient of the same age who are not in nursing homes.

The UC Irvine study focused on the rapid growth of community-associated MRSA.  This MRSA variation is a new breed of the bacteria that afflicts healthy people.  Community-associated MRSA originates in the general population outside of a nursing home or hospital environment and is later introduced to the closed population.  The UC Irvine researchers noted that 25% of all MRSA infections found in their study were community-associated.

Most previous studies have examined MRSA within the hospital context.  This new study has confirmed that the nursing home environment is conducive to spreading MRSA as residents were less likely to have MRSA when they were admitted than later in their nursing home stay.

The UC Irvine researchers also found that community-associated MRSA was more prevalent in nursing homes with younger populations.  This might seem initially surprising and is likely due to two factors.  First, these younger individuals are more likely to be active outside of the nursing home in places like schools and gyms where it is easy to come in contact with MRSA.  Second, once inside of the nursing home, these younger patients are more likely to be active throughout the nursing home thus taking the MRSA to all corners of the facility.  Researchers also believe that community-associated MRSA will rapidly spread in hospitals because nursing home patients are often admitted directly from their nursing home.

Essentially, nursing homes breed MRSA because they encourage residents to be social and MRSA is as easy to spread as the common cold.  While MRSA can be spread to new carriers by skin-to-skin contact, being a carrier does not mean you will also have an infection.  MRSA must enter the body through some sort of wound or skin opening.   MRSA can lead to pneumonia, abscesses, and bloodstream infections.

Taking this new report into consideration, nursing homes will have to re-evaluate their standard procedures if they are going to successfully combat community-associated MRSA.  I hope they are up to this challenge because The last thing residents and families need is one more nursing home problem to worry about.

The full report is available in the March issue of Infection Control and Hospital Epidemiology.