Arguably the best-known hospital germ, MRSA continues to pose major challenges to healthcare systems worldwide and is a particular risk in immunodeficiency settings. A recent study looked at MRSA in nursing homes for the elderly.
Thanks in part to modern medicine, there’s been an increase in people’s life expectancy. Experts estimate that by 2050, there will be over two billion people who are 60 years or older [1]. According to the United Nations (UN) report, this would represent a quarter of the total global population [2]. This will inevitably lead to an increase in the number of people in need of care in old people’s homes and nursing homes. At the same time, the risk of antibiotic resistance continues to increase. In Europe, for example, infections with antibiotic-resistant bacteria rose from 240,000 in 2007 to 600,000 in 2015 [3]. Experts predict 10 million associated deaths per annum worldwide by 2050—a dramatic scenario [4].
MRSA – a dreaded hospital germ
Researchers have recently conducted a comprehensive study on the status quo of this well-known resistant pathogen and published their findings in the journal Antimicrobial Resistance & Infection Control. Methicillin-resistant Staphylococcus aureus—MRSA for short—was first detected in 1960, more or less immediately after the development of the antibiotic methicillin in 1959. Today, the MRSA germ is feared not only in hospitals, but also nursing homes, where it encounters vulnerable persons [5].
MRSA in nursing homes
The scientists investigated how widespread MRSA is in nursing homes worldwide. To do so, the team led by Amir Hossein Hasanpour evaluated 119 studies from 29 countries published on the topic between 1980 and 2022.
Among the most important findings of the work was the high MRSA colonization among nursing home residents. The researchers determined there was a prevalence of 14.69 percent. This value is ten times higher than in the general population [6].
The results also show a heterogeneous picture from a geographical perspective. For example, the prevalence of MRSA colonization among nursing home residents in the countries studied in the Americas is over 22 percent, whereas the countries in Europe have a prevalence of 10.93 percent.
The study authors reason that the generally high prevalence is due to possible cross-contamination between the elderly in nursing homes and the introduction of infections when new residents are admitted from healthcare facilities such as hospitals. Other potential reasons for the high MRSA prevalence include immune system impairment and overuse of antibiotics, according to experts in the field.
Infection prevention is the top priority
The study shows that MRSA is more widespread than average among the elderly. Against the background of demographic developments in the coming decades, there is undoubtedly a need for effective measures to further contain MRSA. These include, among other things, careful hand hygiene.
In its most recent recommendation on MRSA containment in medical and nursing facilities, the Commission for Hospital Hygiene and Infection Prevention at the Robert Koch Institute (KRINKO) describes the benefits of hand hygiene in significantly reducing MRSA prevalence [7].
Studie zu MRSA in Altenpflegeheimen: Hasanpour, A.H., Sepidarkish, M., Mollalo, A. et al. The global prevalence of methicillin-resistant Staphylococcus aureus colonization in residents of elderly care centers: a systematic review and meta-analysis. Antimicrob Resist Infect Control 12, 4 (2023). https://doi.org/10.1186/s13756-023-01210-6
Weitere Literatur zum Artikel MRSA in Altenpflegeheimen:
[1] Naja, S., Makhlouf, M. M. E. D., & Chehab, M. A. H. (2017). An ageing world of the 21st century: a literature review. Int J Community Med Public Health, 4(12), 4363-9.
[2] United Nations, Department of Economic and Social Affairs, Population Division (2017). World Population Ageing 2017 – Highlights (ST/ESA/SER.A/397).
[3] Cassini A., Högberg, L.D., Plachouras, D. et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis, The Lancet Infectious Diseases, 2018; DOI: 10.1016/S1473-3099(18)30605-4.
[4] O‘Neill, J. Tackling drug-resistant infections globally: final report and recommendations. 2016
[5] Cassone M, Mody L. Colonization with multidrug-resistant organisms in nursing homes: scope, importance, and management. Curr Geriatr Rep. 2015;4(1):87–95.
[6] Salgado CD, Farr BM, Calfee DP. Community-acquired methicillin-resistant Staphylococcus aureus: a meta-analysis of prevalence and risk factors. Clin Infect Dis. 2003;36(2):131–9
[7] Ruscher, C. (2014). Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen: Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut.
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