{"doi":"10.1111/jgs.19189","title":"Characteristics of nursing homes with high rates of invasive methicillin‐resistant <i>Staphylococcus aureus</i> infections","abstract":"BACKGROUND: Nursing home residents experience a large burden of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections. Data are limited regarding nursing home characteristics associated with differences in facility-level invasive MRSA rates. METHODS: We analyzed 2011-2015 data from CDC's Emerging Infections Program (EIP) active population- and laboratory-based surveillance for invasive MRSA cases within seven states. A nursing home-onset case was defined as MRSA cultured from a normally sterile site in a person living in a nursing home 3 days before culture collection. Facility rates were calculated as nursing home-onset cases per 100,000 resident-days. Nursing home resident-day denominators and facility characteristics were obtained from four Centers for Medicare & Medicaid Services (CMS) datasets. A general estimating equations model with a logit link assessed characteristics of the facilities with highest rates comprising 50% of nursing home MRSA cases (\"high rates\"). RESULTS: The 626 nursing homes in the surveillance area had 2824 invasive MRSA cases; 82% of facilities had at ≥1 case. The 20% of facilities with highest rates (≥3.84 cases/100,000 resident-days) had 50% of nursing home-onset cases. In multivariable regression, facilities with high rates were more likely to have CMS-derived characteristics of presence of a resident with a multidrug-resistant organism; or greater proportions of residents who were male, were short stay (in the facility <100 days), had a nasogastric or percutaneous gastrostomy tube, or require extensive assistance with bed repositioning; and more likely to be in an EIP area with higher hospital-onset MRSA rates. Higher registered nurses staffing levels (hours/resident/day) and higher proportions of White residents were associated with lower rates. CONCLUSIONS: Facilities with higher invasive MRSA rates served residents with more clinical and functional care needs. Increasing registered nurse staffing in high-risk facilities might assist with reduction of invasive MRSA rates. These findings could help prioritize nursing homes for future MRSA prevention work.","journal":"Journal of the American Geriatrics Society","year":2025,"id":540135,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8134,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1029451,"name":"Kelly A. Jackson","orcid":"0000-0001-5398-0135","position":1,"is_corresponding":false},{"id":225440,"name":"Kelly M Hatfield","orcid":"0000-0003-1035-8420","position":2,"is_corresponding":false},{"id":225446,"name":"Prabasaj Paul","orcid":"0000-0002-4096-6171","position":3,"is_corresponding":false},{"id":373433,"name":"Rongxia Li","orcid":"0000-0003-0664-4803","position":4,"is_corresponding":false},{"id":272986,"name":"Joelle Nadle","orcid":null,"position":5,"is_corresponding":false},{"id":314163,"name":"Susan Petit","orcid":"0000-0001-6057-5007","position":6,"is_corresponding":false},{"id":271477,"name":"Susan M. Ray","orcid":"0000-0002-6327-088X","position":7,"is_corresponding":false},{"id":281657,"name":"Lee H. Harrison","orcid":"0000-0002-3787-2705","position":8,"is_corresponding":false},{"id":1428005,"name":"Laura Jeffrey","orcid":null,"position":9,"is_corresponding":false},{"id":91701,"name":"Ruth Lynfield","orcid":"0000-0002-7741-1284","position":10,"is_corresponding":false},{"id":1428006,"name":"Carmen Bernu","orcid":null,"position":11,"is_corresponding":false},{"id":218479,"name":"Ghinwa Dumyati","orcid":"0000-0002-3634-2841","position":12,"is_corresponding":false},{"id":273008,"name":"Anita Gellert","orcid":null,"position":13,"is_corresponding":false},{"id":254225,"name":"William Schaffner","orcid":"0000-0002-1375-8078","position":14,"is_corresponding":false},{"id":308128,"name":"Tiffanie Markus","orcid":"0000-0001-8741-3729","position":15,"is_corresponding":false},{"id":264501,"name":"Runa H. Gokhale","orcid":"0000-0003-3377-1701","position":16,"is_corresponding":false},{"id":373513,"name":"Nimalie D. 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