Background: Residential care homes for the elderly (RCHEs) are considered potential reservoirs for transmission of Methicillin-resistant Staphylococcus aureus (MRSA). Infection control strategies have been introduced in RCHEs to curb the spread of MRSA. However, the effectiveness of these strategies in reducing MRSA is questionable. MRSA has remained prevalent in economically well-developed regions such as UK and the US despite the implementation of multiple intervention programs. We aim to investigate the characteristics of residents associated with MRSA colonization after implementation of common infection control strategies. Methods & Materials: Residents from selected RCHEs in Kwai Tsing and Tsuen Wan district in New Territories West, Hong Kong were recruited from March 2011 to April 2012. They were interviewed about their health condition and nasal specimens for MRSA screening twice in the study period, with 2-13 months apart. Additional wound specimens were also collected if wounds were identified. Infection control intervention was represented by healthcare staff training and education in the study RCHEs between two screening tests. We defined subjects as being colonized with MRSA if either nasal or wound specimen was tested positive. A multivariable random-effect regression model on follow-up MRSA colonization status was applied. Results: A total of 1832 residents from 32 RCHEs were recruited. The overall point prevalence of MRSA colonisation during the follow-up (after implementation of the training program) was 14.5%(265/1832). Upon adjusting for age, the model which best describes the association between follow-up MRSA colonization and health condition of residents includes the following characteristics: Low mobility indicated by Barthel Index 50 or below (adjusted OR = 1.79;1.23,2.60), presence of skin conditions (adjusted OR = 7.72;4.15,14.36), use of medical device (adjusted OR = 2.25;1.55, 3.24) and presence of MRSA at baseline (OR = 5.23;3.81,7.19). Conclusion: We identified a strong association between health conditions of residents and MRSA colonization. MRSA colonization among residents with low mobility suggested that the service setting and environmental contamination may possibly be sources of MRSA transmission. Device care should be a crucial component in the strategic plan, as shown by the association of colonisation with the use of the medical device. Our findings highlighted the importance of the evaluation of intervention strategies for informing infection control policies.