Study of methicillin-resistant Staphylococcus aureus colonization among intermediate care facilities patients.

Purpose. - Prevalence of methicillin-resistant Staphylococcus aureus is hig h in the Poitiers teaching hosiptal, particularly in the intermediate care facilities. We performed a survey of methicillin-resistant Staphylococcus a ureus colonization in the intermediate care facilities and 265 patients wer e included. Methods. - Nasal, cutaneous and wound swab cultures were done at the time o f admission and at the time of the patients' departure. A decolonization pr ocedure of methicillin-resistant Staphylococcus aureus carriers was perform ed using nasal application of fusidic acid and different soaps for the skin . At entry, 17.7% of patients were methicillin-resistant Staphylococcus aur eus carriers (of at least one location). At departure, 30.4% were methicill in-resistant Staphylococcus aureus carriers. Among methicillin-resistant St aphylococcus aureus non-carriers at entry, 24.3% became methicillin-resista nt Staphylococcus aureus carriers. Results. - The principal risk factor of carriage was the initial presence o f a wound (RR = 3.6). The incidence rate of methicillin-resistant Staphyloc occus aureus infection among the 265 patients included was 3%. Conclusion. - The systematic screening of patients at the time of admission is expensive and isolation technically hard to manage in the Intermediate care facilities. The risk factor we found in this study allow us to propose a 'light' screening limited to patients with wounds. (C) 2001 Editions sci entifiques et medicales Elsevier SAS.