RISK-FACTORS FOR METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS (MRSA) INFECTION IN A JAPANESE GERIATRIC HOSPITAL

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.