Adverse events associated with methicillin-resistant Staphylococcus aureus in a nursing home.

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Abstract
METHICILLIN-resistant Staphylococcus aureus (MRSA) has generated concern and confusion among nursing home practitioners. The potential adverse events driving these concerns include transmission and infection, as well as regulatory deficiencies and malpractice litigation. Methicillin-resistant S aureus might cause outbreaks or infections rendered lethal by misguided empiric antibiotic therapy.1-3 Previously, some nursing homes refused to admit patients with MRSA because the elaborate and restrictive isolation precautions used by hospitals were considered necessary for indefinite periods. The indefinite application of restrictive isolation precautions is labor intensive and might be a personal hardship for the resident. In a longitudinal study, Terpenning et al4 found that gram-negative rods resistant to gentamicin and/or ceftriaxone therapy were less prevalent colonizers than MRSA but posed a greater infection risk to residents. These organisms, however, do not engender the same level of concern. More information is needed to assist nursing home staff in the management of MRSA.