Universal screening for methicillin-resistant (MRSA) entails additional costs, and there is no consensus for targeted screening for high-risk units. The aims of this study were to determine the prevalence of MRSA in geriatric care units, and to identify the factors associated with MRSA colonization on admission. This retrospective case–control study (1:1) in the geriatric care unit of six Belgian hospitals covered the period from 1 January 2021 to 31 December 2022. Cases were patients with a positive MRSA screening result within 48 h of admission to the geriatric care unit, and controls were patients with a negative screening result. In total, 556 patients were included in this study (278 in each group). Prevalence per 100 admissions for the total sample was 2.3 [95% confidence interval (CI) 2.2–2.6]. Significant multi-variate factors associated with MRSA carriage on admission were: history of MRSA, nursing home origin, and chronic skin lesions. Applying these three factors would give an area under the receiver operating characteristic (ROC) curve of 0.73 (95% CI 0.71–0.77), and would allow screening to be carried out in only 55.4% of cases (95% CI 51.2–59.6%). Using these factors as screening criteria in geriatric care units could significantly reduce the number of patients screened for MRSA, while maintaining satisfactory sensitivity and specificity.

中文翻译：

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老年护理病房入院时耐甲氧西林金黄色葡萄球菌定植的患病率和相关因素：对筛查实践的影响

普遍筛查耐甲氧西林 (MRSA) 需要额外费用，而且对于高风险单位的针对性筛查尚未达成共识。本研究的目的是确定老年护理单位中 MRSA 的患病率，并确定与入院时 MRSA 定植相关的因素。这项回顾性病例对照研究 (1:1) 在比利时六家医院的老年护理病房进行，涵盖时间为 2021 年 1 月 1 日至 2022 年 12 月 31 日。病例为入院后 48 小时内 MRSA 筛查结果呈阳性的患者单位，对照是筛查结果为阴性的患者。本研究总共纳入 556 名患者（每组 278 名）。总样本中每 100 名入院患者的患病率为 2.3 [95% 置信区间 (CI) 2.2–2.6]。与入院时 MRSA 携带相关的重要多变量因素包括：MRSA 病史、疗养院血统和慢性皮肤病变。应用这三个因素将使受试者工作特征 (ROC) 曲线下面积为 0.73 (95% CI 0.71–0.77)，并且只允许在 55.4% 的病例中进行筛查 (95% CI 51.2–59.6%) ）。使用这些因素作为老年护理单位的筛查标准可以显着减少筛查 MRSA 的患者数量，同时保持令人满意的敏感性和特异性。