Methicillin Resistant Staphylococcus aureus (MRSA): An Interim Report of Carriage and Conversion Rates in Nursing Students

Abstract

To evaluate and characterize MRSA and staphylococci carriage and conversion rates in nursing students across clinical semester rotations and to describe risk factors. A prospective, longitudinal cohort design (interim report) with three times of measurement. Data collected between August 2010 and May 2011 (ongoing longitudinal study to May 2012). Institutional Review Board approval (2010F5693). Texas State University, San Marcos, TX. Eighty-seven nursing students. A positive MRSA swab represented an end-point for a participant. Intervention offered was bactroban (mupirocin) for nasal decolonization and an oral antibiotic, doxycycline; posttreatment collection to verify decolonization prior to next clinical rotation. Screening for Staphylococcus aureus and MRSA identification; confirmation and antibiotic susceptibility by Vitek 2. Self-administered questionnaires collected demographics and risk factors. Generalized estimating equations calculated population-averaged panel logistic regression models allowing for an AR(1) error by Stata version 12. MRSA colonization did not increase. S. aureus prevalence (20-26%). Species prevalence other than S. aureus increased (9.2% to 80%). The following associations were found to be statistically significant: boil or skin infection odds with S. aureus (OR = 2.43, p < .05), working or volunteering in healthcare facility odds with S. other (OR = 2.72, p < .05) and gym and sports activities odds with S. other (OR = 4.98, p < .001). MRSA colonization did not increase. Knowledge and understanding of MRSA (risks) may play a role in compliance and barrier precautions. S. aureus colonization remained stable (25-30%). Species colonization other than S. aureus (e.g. S. epidermis, S. haemolyticus) increased to significant levels.