Newly identified risk factors for MRSA carriage in The Netherlands

W S N Lekkerkerk, A Haenen, M A B van der Sande, T Leenstra, S de Greeff, A Tjon-A-Tsien, J H Richardus, N van de Sande-Bruinsma, M C Vos, Aura Timen

Research output: Contribution to JournalArticleAcademicpeer-review


OBJECTIVES: To elucidate new risk factors for MRSA carriers without known risk factors (MRSA of unknown origin; MUO). These MUO carriers are neither pre-emptively screened nor isolated as normally dictated by the Dutch Search & Destroy policy, thus resulting in policy failure.

METHODS: We performed a prospective case control study to determine risk factors for MUO acquisition/carriage (Dutch Trial Register: NTR2041). Cases were MUO carriers reported by participating medical microbiological laboratories to the RIVM from September 1st 2011 until September 1st 2013. Controls were randomly selected from the community during this period.

RESULTS: Significant risk factors for MUO in logistic multivariate analysis were antibiotic use in the last twelve months, aOR 8.1 (5.6-11.7), screened as contact in a contact tracing but not detected as a MRSA carrier at that time, aOR 4.3 (2.1-8.8), having at least one foreign parent, aOR 2.4 (1.4-3.9) and receiving ambulatory care, aOR 2.3 (1.4-3.7). Our found risk factors explained 83% of the MUO carriage.

CONCLUSIONS: Identifying new risk factors for MRSA carriers remains crucial for countries that apply a targeted screening approach as a Search and Destroy policy or as vertical infection prevention measure.

Original languageEnglish
Article numbere0188502
Pages (from-to)e0188502
JournalPLoS ONE
Issue number11
Publication statusPublished - 2017
Externally publishedYes


  • Carrier State/microbiology
  • Case-Control Studies
  • Humans
  • Methicillin-Resistant Staphylococcus aureus/isolation & purification
  • Netherlands/epidemiology
  • Population Surveillance
  • Prospective Studies
  • Risk Factors
  • Staphylococcal Infections/epidemiology


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