Meticillin-resistant Staphylococcus aureus carriage among district nurse patients and medical admissions in a UK district

SummaryWe studied the prevalence of meticillin-resistant Staphylococcus aureus (MRSA) carriage in two defined community populations and assessed risk factors associated with MRSA colonization. The study was designed as a population prevalence survey and was carried out in the medical assessment unit (MAU) of the local hospital and the district nurse patient (DNP) population in Huntingdonshire. In all, 162 participants were recruited, 91 were from MAU and 71 from the DNP population. MRSA was found in 21.1% [confidence interval (CI): 11.6–30.4] of the DNP study population and 6.6% (CI 1.5–11.7) of the MAU study population. Factors found to be significantly associated with MRSA colonization were age (76.6 years, P = 0.008), presence of wound/ulcer (P = 0.012), hospital admission in the past year (P = 0.017), past history of MRSA (P < 0.001), and antibiotic use in the preceding six months (P = 0.016). The only independent predictor for MRSA colonization was found to be past history of MRSA (adjusted odds ratio: 8.53; CI: 2.11–34.43; P = 0.003). The DNP population are a significant reservoir for MRSA in the community and policies on screening high-risk patients need to reflect this.