scholarly journals Similarities and Differences in Risk Factors for Vancomycin-resistant Enterococcus Colonization between an Acute Hospital and its affiliated Intermediate- and Long-term care facilities

2018 ◽  
Vol 73 ◽  
pp. 261
Author(s):  
D. Tan ◽  
J.-W. Lim ◽  
P.-Y. Hon ◽  
A. Chow
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Acute Hospital ◽  
Vancomycin Resistant Enterococcus ◽  
Term Care ◽  
Care Facilities ◽  
Vancomycin Resistant ◽  
Similarities And Differences

scholarly journals Comparative Epidemiology of Vancomycin-Resistant Enterococci Colonization in an Acute-Care Hospital and Its Affiliated Intermediate- and Long-Term Care Facilities in Singapore

2018 ◽  
Vol 62 (12) ◽  
Author(s):  
Damon Tan ◽  
Htet Lin Htun ◽  
Jocelyn Koh ◽  
Kala Kanagasabai ◽  
Jia-Wei Lim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Length Of Stay ◽  
Long Term Care ◽  
Term Care ◽  
Vancomycin Resistant Enterococci ◽  
Care Facilities ◽  
Independent Risk Factors ◽  
Vancomycin Resistant

ABSTRACTVancomycin-resistant enterococci (VRE) are an important cause of nosocomial infections in acute-care hospitals (ACHs), intermediate-care facilities (ITCFs), and long-term care facilities (LTCFs). This study contemporaneously compared the epidemiology and risk factors for VRE colonization in different care settings in a health care network. We conducted a serial cross-sectional study in a 1,700-bed ACH and its six closely affiliated ITCFs and LTCFs in June and July of 2014 to 2016. Rectal swab or stool specimens were cultured for VRE. Multivariable logistic regression was used to assess for independent risk factors associated with VRE colonization. Of 5,357 participants, 523 (9.8%) were VRE colonized. VRE prevalence was higher in ACHs (14.2%) than in ITCFs (7.6%) and LTCFs (0.8%). Common risk factors between ACHs and ITCFs included prior VRE carriage, a longer duration of antibiotic therapy, surgery in the preceding 90 days, and the presence of a skin ulcer. Independent risk factors specific to ACH-admitted patients were prior methicillin-resistantStaphylococcus aureuscarriage, a higher number of beds per room, prior proton pump inhibitor use, and a length of stay of >14 days. For ITCFs, a length of stay of >14 days was inversely associated with VRE colonization. Similarities and differences in risk factors for VRE colonization were observed between health care settings. VRE prevention efforts should target the respective high-risk patients.

Design and Development of a Web-based Delirium Preventive Application for Long-term Care Facilities: A Methodological Study (Preprint)

2020 ◽  
Author(s):  
Kyoung Ja Moon ◽  
Chang-Sik Son ◽  
Jong-Ha Lee ◽  
Mina Park
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Cloud System ◽  
Evidence Based ◽  
Methodological Study ◽  
Term Care ◽  
Web Based ◽  
Care Facilities ◽  
Delirium Prevention

BACKGROUND Long-term care facilities demonstrate low levels of knowledge and care for patients with delirium and are often not properly equipped with an electronic medical record system, thereby hindering systematic approaches to delirium monitoring. OBJECTIVE This study aims to develop a web-based delirium preventive application (app), with an integrated predictive model, for long-term care (LTC) facilities using artificial intelligence (AI). METHODS This methodological study was conducted to develop an app and link it with the Amazon cloud system. The app was developed based on an evidence-based literature review and the validity of the AI prediction model algorithm. Participants comprised 206 persons admitted to LTC facilities. The app was developed in 5 phases. First, through a review of evidence-based literature, risk factors for predicting delirium and non-pharmaceutical contents for preventive intervention were identified. Second, the app, consisting of several screens, was designed; this involved providing basic information, predicting the onset of delirium according to risk factors, assessing delirium, and intervening for prevention. Third, based on the existing data, predictive analysis was performed, and the algorithm developed through this was calculated at the site linked to the web through the Amazon cloud system and sent back to the app. Fourth, a pilot test using the developed app was conducted with 33 patients. Fifth, the app was finalized. RESULTS We developed the Web_DeliPREVENT_4LCF for patients of LTC facilities. This app provides information on delirium, inputs risk factors, predicts and informs the degree of delirium risk, and enables delirium measurement or delirium prevention interventions to be immediately implemented with a verified tool. CONCLUSIONS This web-based application is evidence-based and offers easy mobilization and care to patients with delirium in LTC facilities. Therefore, the use of this app improves the unrecognized of delirium and predicts the degree of delirium risk, thereby helping initiatives for delirium prevention and providing interventions. This would ultimately improve patient safety and quality of care. CLINICALTRIAL none

scholarly journals Long-Term Care Facilities Are Reservoirs for Antimicrobial-Resistant Sequence Type 131 Escherichia coli

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Mary J. Burgess ◽  
James R. Johnson ◽  
Stephen B. Porter ◽  
Brian Johnston ◽  
Connie Clabots ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Gel Electrophoresis ◽  
Long Term Care ◽  
Pulsed Field Gel Electrophoresis ◽  
Sequence Type ◽  
Term Care ◽  
E Coli ◽  
Care Facilities

Abstract Background.  Emerging data implicate long-term care facilities (LTCFs) as reservoirs of fluoroquinolone-resistant (FQ-R) Escherichia coli of sequence type 131 (ST131). We screened for ST131 among LTCF residents, characterized isolates molecularly, and identified risk factors for colonization. Methods.  We conducted a cross-sectional study using a single perianal swab or stool sample per resident in 2 LTCFs in Olmsted County, Minnesota, from April to July 2013. Confirmed FQ-R E. coli isolates underwent polymerase chain reaction-based phylotyping, detection of ST131 and its H30 and H30-Rx subclones, extended virulence genotyping, and pulsed-field gel electrophoresis (PFGE) analysis. Epidemiological data were collected from medical records. Results.  Of 133 fecal samples, 33 (25%) yielded FQ-R E. coli, 32 (97%) of which were ST131. The overall proportion with ST131 intestinal colonization was 32 of 133 (24%), which differed by facility: 17 of 41 (42%) in facility 1 vs 15 of 92 (16%) in facility 2 (P = .002). All ST131 isolates represented the H30 subclone, with virulence gene and PFGE profiles resembling those of previously described ST131 clinical isolates. By PFGE, certain isolates clustered both within and across LTCFs. Multivariable predictors of ST131 colonization included inability to sign consent (odds ratio [OR], 4.16 [P = .005]), decubitus ulcer (OR, 4.87 [ P = .04]), and fecal incontinence (OR, 2.59 [P = .06]). Conclusions.  Approximately one fourth of LTCF residents carried FQ-R ST131 E. coli resembling ST131 clinical isolates. Pulsed-field gel electrophoresis suggested intra- and interfacility transmission. The identified risk factors suggest that LTCF residents who require increased nursing care are at greatest risk for ST131 colonization, possibly due to healthcare-associated transmission.

scholarly journals Patients in Long-Term Care Facilities: A Reservoir for Vancomycin-Resistant Enterococci

2002 ◽  
Vol 34 (4) ◽  
pp. 441-446 ◽  
Author(s):  
Marnie L. Elizaga ◽  
Robert A. Weinstein ◽  
Mary K. Hayden
Keyword(s):  
Long Term Care ◽  
Term Care ◽  
Vancomycin Resistant Enterococci ◽  
Care Facilities ◽  
Vancomycin Resistant

Evidence of Delays in Transferring Patients With Methicillin-Resistant Staphylococcus aureus or Vancomycin-Resistant Enterococcus to Long-Term–Care Facilities

2000 ◽  
Vol 21 (4) ◽  
pp. 270-271 ◽  
Author(s):  
Elizabeth A. Bryce ◽  
Shelley M. Tiffin ◽  
Judith L. Isaac-Renton ◽  
Charles J. Wright
Keyword(s):  
Staphylococcus Aureus ◽  
Long Term Care ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Retrospective Case ◽  
Term Care ◽  
Methicillin Resistant ◽  
Care Facilities ◽  
Vancomycin Resistant ◽  
Control Study

This retrospective case-control study examined whether there was a difference in length of time awaiting long-term-care lacement for patients identified as having methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococcus compared to controls. Thirty-nine patients with methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococcus waited for placement an average of 61 days longer than controls (P<.0002). The average number of requests for placement was 2.5 compared to 1.7 for controls (P=.015).

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