MRSA in Nursing Homes

Nursing Homes have long had a MRSA (Methicillin resistant Staphylococcus aureus) problem that is very close to the well documented hospital acquired MRSA challenges. This problem also extends to any residential facility that provides health care. Here is a short list of some of these types of facilities outside the traditional hospital that may be contributing to the MRSA problem:

• skilled nursing facility


• rehabilitation centers


• long term care facilities


• retirement centers


• assisted living centers


• group homes


• senior care


• residential homes


• home care services

A common misconception is that these facilities primarily provide care to the aged population. This type of medical facility can be a place of residence for anyone who requires constant nursing care and have significant deficiencies with activities of daily living. Residents include the elderly and younger adults with physical disabilities. Unfortunately, a patient may enter a center for care after an illness or accident and contract MRSA through no fault of their own.

Nursing homes and other extended care facilities have long known about and monitored the resistance patterns of infection causing organisms. This is important information for them to know because the "hospital acquired" or nosocomial infection rate is something they must control. Choices of antibiotics for these health care facilities are greatly influenced by this data. Just like other medical facilities, MRSA in nursing homes is caused by person to person contact, contaminated equipment and the environment. With the smaller staff at these facilities, attention to sanitation procedures can be a real problem.

These facilities generally have a sicker patient population with many health issues requiring diligent care. Long term care patients may have had multiple infections with a greater probability of the development of resistance because of repeated exposure to antibiotic treatments. This patient population routinely undergoes catheterization, ventilation, central lines and intubation - all invasive procedures which can create additional opportunities for MRSA infection. Bed ridden patients are also highly susceptible to the development of bed sores (also called decubitus ulcers). Multiple hospitalizations may contribute to the problem in the long term care facility or vice versa - the nursing home admissions may contribute to the resistance seen in hospitals. Hospitals are beginning to swab patients as they are admitted from nursing homes.

Whatever the source, MRSA infection In the elderly and immunocompromised patient can have devastating consequences. MRSA infects wounds, the respiratory system, or the urinary tract. A symptomatic resident in these facilities, who has methicillin resistant staph aureus isolated from the urine, should even be evaluated for the possibility of sepsis.

As our population ages, we need to be concerned about MRSA in the long term care facility. This could prove to have major implications on how well our loved ones live out their later years. Families should be on the watch out for MRSA outbreaks in the long term care facility and be an advocate for the inpatient who may not be able to speak for themselves.