Epidemiology and Infection

Methicillin-resistant Staphylococcus aureus (MRSA) in nursing homes in a major UK city: an anonymized point prevalence survey

A. P. FRAISE a1, K. MITCHELL a1, S. J. O’BRIEN a2, K. OLDFIELD a1 and R. WISE a1
a1 Department of Medical Microbiology, City Hospital, Dudley Road, Birmingham B18 7QH
a2 Department of Infection, The Medical School, University of Birmingham, Edgbaston, Birmingham B15 2TT


An anonymized point-prevalence survey of methicillin-resistant Staphylococcus aureus (MRSA) carriage was conducted amongst a stratified random sample of nursing home residents in Birmingham, UK, during 1994. Microbiological sampling from noses, fingers and the environment was undertaken. Information about potential risk factors for the acquisition of MRSA was gathered. MRSA was isolated from cultures of the nose or fingers of 33 of the 191 residents who took part in the study (17%) but only 1 of the 33 positive residents had a clinical infection. Although just 10 of the 87 environmental samples were MRSA positive, there was some environmental contamination in most homes. Risk factors for MRSA carriage were hospital admission within the last year (relative prevalence 2·09, 95% CI 1·13–3·88; P < 0·05) and surgical procedures within the last year (relative prevalence 4·02, 95% CI 2·18–7·43; P = 0·002). Phage-typing of the strains revealed similarities with those circulating in Birmingham hospitals. These findings suggest that the prevalence of MRSA in nursing homes in Birmingham was high, and that the strains may have originated in hospitals.

(Accepted August 21 1996)