Low prevalence of colonization with multidrug-resistant gram-negative bacteria in long-term care facilities in Graz, Austria

2018 ◽  
Vol 46 (1) ◽  
pp. 76-80 ◽  
Author(s):  
Eva Leitner ◽  
Elisabeth Zechner ◽  
Elisabeth Ullrich ◽  
Gernot Zarfel ◽  
Josefa Luxner ◽  
...  
Keyword(s):  
Long Term Care ◽  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
Term Care ◽  
Gram Negative ◽  
Care Facilities ◽  
Low Prevalence

scholarly journals Prevalence of Ceftriaxone-and Ceftazidime-Resistant Gram-Negative Bacteria in Long-Term–Care Facilities

2001 ◽  
Vol 22 (4) ◽  
pp. 193-194 ◽  
Author(s):  
Lona Mody ◽  
Suzanne F. Bradley ◽  
Larry J. Strausbaugh ◽  
Robert R. Muder
Keyword(s):  
Long Term Care ◽  
Gram Negative Bacteria ◽  
Term Care ◽  
Gram Negative ◽  
Care Facilities

Multidrug-Resistant Gram-Negative Bloodstream Infections among Residents of Long-Term Care Facilities

2014 ◽  
Vol 35 (5) ◽  
pp. 519-526 ◽  
Author(s):  
Indumathi Venkatachalam ◽  
Hsu Li Yang ◽  
Dale Fisher ◽  
David C. Lye ◽  
Ling Moi Lin ◽  
...  
Keyword(s):  
Risk Factor ◽  
Independent Risk Factor ◽  
Long Term Care ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Term Care ◽  
Gram Negative ◽  
Singapore General Hospital ◽  
Care Facilities

Objective.Prevalence of multidrug-resistant (MDR) gram-negative (GN) bacteria is increasing globally and is complicated by patient movement between acute and long-term care facilities (LTCFs). In Asia, the contribution of LTCFs as a source of MDR GN infections is poorly described. We aimed to define the association between residence in LTCFs and MDR GN bloodstream infections (BSIs).Design.Secondary analysis of data from an observational cohort.Setting.Two tertiary referral hospitals in Singapore, including the 1,400-bed Tan Tock Seng Hospital and the 1,600-bed Singapore General Hospital.Participants.Adult patients with healthcare-onset (HCO) or hospital-onset (HO) GN BSI.Methods.Patients were identified from hospital databases using standard definitions. Risk factors for both MDR GN HCO and HO BSI were analyzed using a multivariable logistic regression model.Results.A total of 675 episodes of GN BSI occurred over a 31-month period. Residence in a LTCF was an independent risk factor for developing MDR GN BSI (odds ratio [OR], 5.1 [95% confidence interval (CI), 2.2–11.9]; P < .01) when antibiotics were not used within the preceding 30 days. This risk persisted beyond the first 48 hours of hospitalization (OR, 3.4 [95% CI, 1.3–9.0]; P = .01). Previous culture growing an MDR organism (OR, 1.8 [95% CI, 1.3–2.7]; P < .01), previous antibiotic use (OR, 1.8 [95% CI, 1.2–2.6]; P < .01), and intensive care unit stay (OR, 2.2 [95% CI, 1.2–3.9]; P = .01), increased the risk of MDR GN BSI.Conclusions.Residence in a LTCF is an independent risk factor for MDR GN BSI. Attempts to contain MDR GN bacteria in large Asian cities, where the proportion of the population that is elderly is projected to increase, should include infection prevention strategies that engage LTCFs.

Acquisition of Multidrug-Resistant Gram-Negative Bacteria: Incidence and Risk Factors within a Long-Term Care Population

2010 ◽  
Vol 31 (11) ◽  
pp. 1148-1153 ◽  
Author(s):  
Erin O'Fallon ◽  
Ruth Kandell ◽  
Robert Schreiber ◽  
Erika M. C. D'Agata
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Bacterial Colonization ◽  
Conditional Logistic Regression ◽  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
Term Care ◽  
Gram Negative

Background and Objective.An improved understanding of the transmission dynamics of multidrug-resistant (MDR) gram-negative bacteria and the mechanism of acquisition in long-term care facilities (LTCFs) could aid in the development of prevention strategies specific to LTCFs. We thus investigated the incidence of acquisition of these pathogens among an LTCF population.Design.Prospective cohort study.Setting.Three separate wards at a 600-bed LTCF in metropolitan Boston, Massachusetts, during the period October 31, 2006, through October 22, 2007.Participants.One hundred seventy-two LTCF residents.Methods.A series of rectal samples were cultured to determine acquisition of MDR gram-negative bacteria, defined as absence of MDR gram-negative bacterial colonization at baseline and de novo recovery of MDR gram-negative bacteria from a follow-up culture. Molecular typing was performed to identify genetically linked strains. A nested matched case-control study was performed to identify risk factors associated with acquisition.Results.Among 135 residents for whom at least 1 follow-up culture was performed, 52 (39%) acquired at least 1 MDR gram-negative organism during the study period. Thirty-two residents (62%) had not been colonized at baseline and had acquired at least 1 MDR gram-negative species at follow-up culture, and 20 residents (38%) were colonized at baseline and had acquired at least I MDR gram-negative species at follow-up culture. The most common coresistance pattern was resistance to extended-spectrum penicillins, ciprofloxacin, and gentamicin (57 isolates [42.5%]). Genetically related strains of MDR gram-negative bacteria were identified among multiple residents and between roommates. On conditional logistic regression analysis, antibiotic exposure during the study period was significantly associated with acquisition of MDR gram-negative bacteria (odds ratio, 5.6 [95% confidence interval, 1.1-28.7];P= .04).Conclusions.Acquisition of MDR gram-negative bacteria occurred frequently through resident-to-resident transmission. Existing infection control interventions need to be reevaluated.

Multidrug-Resistant Gram-Negative Bacteria in a Long-Term Care Facility: Prevalence and Risk Factors

2008 ◽  
Vol 56 (7) ◽  
pp. 1276-1280 ◽  
Author(s):  
Aurora Pop-Vicas ◽  
Susan L. Mitchell ◽  
Ruth Kandel ◽  
Robert Schreiber ◽  
Erika M. C. D'Agata
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Care Facility ◽  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
Term Care ◽  
Gram Negative ◽  
Term Care Facility ◽  
Long Term Care Facility

scholarly journals Influx of Multidrug-Resistant, Gram-Negative Bacteria in the Hospital Setting and the Role of Elderly Patients With Bacterial Bloodstream Infection

2009 ◽  
Vol 30 (4) ◽  
pp. 325-331 ◽  
Author(s):  
Aurora Pop-Vicas ◽  
E. Tacconelli ◽  
Stefan Gravenstein ◽  
Bing Lu ◽  
Erika M. C. D'Agata
Keyword(s):  
Elderly Patients ◽  
Hospital Admission ◽  
Long Term Care ◽  
Clinical Epidemiology ◽  
Hospital Setting ◽  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
Term Care ◽  
Gram Negative

Background.Multidrug-resistant (MDR) gram-negative bacteria are reported increasingly frequently among isolates recovered from elderly patients. The clinical epidemiology of bloodstream infection (BSI) due to MDR gram-negative bacteria among elderly patients is unknown.Objective.To characterize the clinical epidemiology of BSI due to MDR gram-negative bacteria among elderly patients at hospital admission in an effort to provide a greater understanding of these serious infections and ultimately to improve patient outcomes.Design.Case-control study.Setting.Tertiary care hospital in Boston, Massachusetts.Patients.Patients 65 years of age and older.Methods.From 1999 to 2007, computerized medical records were reviewed for BSI due to MDR gram-negative bacteria within 48 hours of hospital admission. Risk factors for BSI due to these bacteria were identified.Results.MDR gram-negative bacteria were recovered from 61 (8%) of 724 elderly patients with BSI caused by gram-negative bacteria. Over the -year study period, the percentage of MDR gram-negative bacteria among bloodstream isolates increased from 2 (1%) of 199 to 34 (16%) of 216. Empiric therapy was ineffective for 38 (63%) of 60 patients with BSI caused by MDR gram-negative bacteria. The variables independently associated with BSI due to these bacteria were as follows: residency in a long-term care facility (odds ratio [OR], 4.9 [95% confidence interval {CI} 1.6–14.9]; P = .006), presence of an invasive device (OR, 6.0 [95% CI, 1.5–23.5]; P = .01), severe sepsis (OR, 7.9 [95% CI, 1.7–37.1]; P = .009), and delayed initiation of effective therapy (OR, 12.8 [95% CI, 3.9–41.1]; P<.001).Conclusion.The 16-fold increase in BSI due to MDR gram-negative bacteria at hospital admission among elderly patients, especially among those who resided in long-term care facilities prior to admission, contributes further to the expanding body of evidence that these patients are the main reservoirs of MDR gram-negative bacteria. Given their contribution to the influx of antimicrobial-resistant bacteria in the hospital setting, infection control interventions that target this high-risk group need to be considered.

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