M. Washio et al., RISK-FACTORS FOR METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS (MRSA) INFECTION IN A JAPANESE GERIATRIC HOSPITAL, Public health, 111(3), 1997, pp. 187-190
A case control study on MRSA infection was carried out, with the purpo
se of evaluating the effect of age, gender, hypoalbuminemia, the limit
ation of activities of daily living (ADL), the administration of antib
iotics and the use of the new cephems which include third generation c
ephalosporins and monobactam and carbapenems, on the occurrence of MRS
A infection among the inpatients in a geriatric hospital. From April 1
991 to March 1994, 285 patients underwent a bacterial culture in the v
arious clinical aspects. 118 patients were positive for MRSA, who were
then used as cases while 167 patients who were negative for MRSA were
used as controls. The level of serum albumin and the ADL score were l
ower in the MRSA group than in the non-MRSA group (P < 0.01) while the
number of antibiotics administered before bacterial culture was great
er in the MRSA group than in the non-MRSA group (P < 0.01). The third
generation cephems were more commonly used in the MRSA positive patien
ts than the negative patients (P < 0.01). Even after controlling for t
he other factors, hypoalbuminemia (OR = 1.73, 95% CI = 1.27-2.36), the
limited ADL (partially limited vs without limitation: OR = 1.88, 95%
CI = 1.19-2.96, completely limited vs without limitation: OR = 2.50, 9
5% CI = 1.64-3.82), the use of antibiotics other than the third genera
tion cephems (vs without antibiotics: OR = 1.73, 95% CI = 1.20-2.50) a
nd the administration of the third generation cephems (vs without anti
biotics: OR = 3.12, 95% CI = 2.16-4.50) increased the risk of MRSA inf
ection.