Rising Threats of MRSA and Carbapenem-Resistant Acinetobacter in Residential Care Homes for the Elderly During COVID-19 in Hong Kong

Methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) and carbapenem-resistant <i>Acinetobacter</i> (CRA) cause significant mortality and morbidity among the elderly population. We conducted a territory-wide point prevalence survey in Hong Kong to estimate the prevalence of MRSA and resistant <i>Acinetobacter</i> among residents of residential care homes of the elderly (RCHEs). A total of 26 RCHEs with 1529 residents were recruited, including 20 private homes and 6 non-private homes. The size of the homes ranged from 13 to 135 residents, with a median of 57 residents. Overall, the prevalence rates of MRSA, CRA, and multidrug-resistant <i>Acinetobacter</i> were 33.9% (95% CI: 31.5-36.3%), 8.1% (95% CI: 6.8-9.6%), and 0.8% (95% CI: 0.4-1.4%), respectively. Private homes had a greater prevalence of MDROs than non-private homes did, whereas RCHEs in the Hong Kong region had a greater prevalence of most resistant organisms, followed by those in the Kowloon region and then those in the New Territories. We detected a high prevalence of MRSA during the COVID-19 pandemic, with additional information on CRA that was not previously known. Continuous surveillance and stringent infection control measures are needed to combat these resistant pathogens among this vulnerable population.