Risk Factors for Colonization With Methicillin-ResistantStaphylococcus aureusin a Long-Term-Care Facility in Slovenia

2005 ◽  
Vol 26 (2) ◽  
pp. 191-195 ◽  
Author(s):  
Petra Vovko ◽  
Matjaz Retelj ◽  
Tjasa Zohar Cretnik ◽  
Borut Jutersek ◽  
Tatjana Harlander ◽  
...  
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Long Term Care ◽  
Hospital Admissions ◽  
Care Facility ◽  
The Elderly ◽  
Term Care ◽  
Long Term Care Facility ◽  
Mrsa Colonization

AbstractObjective:To evaluate risk factors associated with methicillin-resistantStaphylococcus aureus(MRSA) colonization in a long-term-care facility (LTCF) for the elderly in Slovenia.Setting:A 351-bed community LTCF for the elderly.Design and Participants:This was a case-control study. MRSA carriage was identified in 102 of 127 residents of the facility's nursing unit. Two swabs were taken: one from the anterior nares and one from the largest skin lesion. If no skin lesions were present, the axillae and the groin area were swabbed. Data were collected regarding gender, age, length of stay in the facility, underlying conditions, functional status, presence of wounds or pressure sores, presence of catheters, antibiotic treatments, and hospital admissions.Results:We detected MRSA in 12 participants. Risk factors independently and significantly associated with MRSA colonization on the multivariate analysis were antibiotic treatments within 1 month before the investigation (odds ratio, 5.087; 95% confidence interval, 1.02 to 25.48;P= .048) and multiple hospital admissions in the 3 months before the investigation (odds ratio, 6.277; 95% confidence interval, 1.31 to 30.05;P= .022).Conclusions:This is the first assessment of risk factors for colonization with MRSA in an LTCF in Slovenia. MRSA poses a problem in this LTCF. Our observations may be valuable in implementing active surveillance cultures in infection control programs in Slovenian LTCFs.

Importance of Bacterial Burden Among Methicillin-Resistant Staphylococcus aureus Carriers in a Long-Term Care Facility

2008 ◽  
Vol 29 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Nimalie D. Stone ◽  
Donna R. Lewis ◽  
H. K. Lowery ◽  
Lyndsey A. Darrow ◽  
Catherine M. Kroll ◽  
...  
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Nasal Swab ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Long Term Care Facility ◽  
Culture Positive ◽  
Epidemiologic Characteristics

Objective.To evaluate the prevalence and transmission of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization, as well as risk factors associated with MRSA carriage, among residents of a long-term care facility (LTCF).Design.Prospective, longitudinal cohort study.Setting.A 100-bed Veterans Administration LTCFParticipants.All current and newly admitted residents of the LTCF during an 8-week study period.Methods.Nasal swab samples were obtained weekly and cultured on MRSA-selective media, and the cultures were graded for growth on a semiquantitative scale from 0 (no growth) to 6 (heavy growth). Epidemiologic data for the periods before and during the study were collected to assess risk factors for MRSA carriage.Results.Of 83 LTCF residents, 49 (59%) had 1 or more nasal swab cultures that were positive for MRSA; 34 (41%) were consistently culture-negative (designated “noncarriers”). Of the 49 culture-positive residents, 30 (36% of the total of 83 residents) had all cultures positive for MRSA (designated “persistent carriers”), and 19 (23% of the 83 residents) had at least 1 culture, but not all cultures, positive for MRSA (designated “intermittent carriers”). Multivariate analysis showed that participants with at least 1 nasal swab culture positive for MRSA were likely to have had previous hospitalization (odds ratio, 3.9) or wounds (odds ratio, 8.2). Persistent carriers and intermittent carriers did not differ in epidemiologic characteristics but did differ in mean MRSA growth score (3.7 vs 0.7; P < .001).Conclusions.Epidemiologic characteristics differed between noncarriers and subjects with at least 1 nasal swab culture positive for MRSA. However, in this LTCF population, only the degree of bacterial colonization (as reflected by mean MRSA growth score) distinguished persistent carriers from intermittent carriers. Understanding the burden of colonization may be important when determining future surveillance and control strategies.

Prevalence and Nosocomial Spread of Methicillin-ResistantStaphylococcus aureusin a Long-Term-Care Facility in Slovenia

2005 ◽  
Vol 26 (2) ◽  
pp. 184-190 ◽  
Author(s):  
Tjasa Zohar Cretnik ◽  
Petra Vovko ◽  
Matjaz Retelj ◽  
Borut Jutersek ◽  
Tatjana Harlander ◽  
...  
Keyword(s):  
Potential Role ◽  
Long Term Care ◽  
Genetic Relatedness ◽  
Care Facility ◽  
The Elderly ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Mrsa Colonization

AbstractObjectives:To determine the prevalence and incidence of methicillin-resistantStaphylococcus aureus(MRSA) colonization among residents and healthcare workers (HCWs) of a long-term-care facility (LTCF), to assess possible routes of nosocomial spread, and to determine genetic relatedness of the isolates.Setting:A 351-bed community LTCF for the elderly.Design and Participants:Study investigators made two visits, approximately 3 months apart, to the facility. Samples for cultures were obtained from 107 residents during the first visit, 91 residents during the second visit, and 38 HCWs.Results:The prevalence of MRSA colonization among residents was 9.3% during the first visit and 8.8% during the second visit. During the first visit, two HCWs were colonized. During the second visit, no HCWs were colonized. The colonization of HCWs suggested a potential role in the transmission of MRSA. Molecular typing showed that two of three roommates in one room had the same strain, whereas two in another room differed from one another. All isolates, except one, belonged to two related clonal groups. It seems that the clonal group to which most isolates belonged had the greatest potential for spreading among both residents and HCWs.Conclusions:Similar prevalence rates of MRSA colonization have been found in other European countries, but such studies have usually involved residents with better functional status than that of the participants in this study. Nosocomial spread of MRSA occurred in the facility examined, but not frequently. More attention should be focused on the hand hygiene of HCWs.

scholarly journals Μελέτη του αποικισμού από Staphylococcus aureus ανθεκτικού στη μεθικιλλίνη (MRSA), στους ασθενείς που προσέρχονται στο νοσοκομείο

2013 ◽  
Author(s):  
Φανή Πλοιαρχοπούλου
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Mrsa Colonization ◽  
Valentine Leukocidin

Purpose: To determine the prevalence and to identify risk factors of MRSA colonization, among patients presenting for hospital admission.Methods: In a tertiary teaching hospital, surveillance cultures from the nares, axillae and inguinal areas were performed at the time of admission for all patients except those admitted in the oncology and hematology unit. Demographic and possible risk factors for colonization were recorded. Antibiotic susceptibility was tested with standard methods and methicillin resistance by the cefoxitin disc method and mec gene detection. Isolates were characterized as CA-MRSA according to their susceptibility pattern. MRSA isolates were tested for Panton Valentine leukocidin (pvl) gene.Results: Swab samples were collected from 2994 patients presenting for admission in two years. Mean patient age was 53 years (median 52) and the female to male ratio of 1.3:1. Staphylococcus aureus was isolated from 473 (15.8%) patients and MRSA from 88 (3%) of the patients (18.8% of colonizing isolates).Detection of colonization was (442/473) 93.4% in the nares, (128/279) 45.9% in the axilla and (157/279) 56.3% in the inguinal area. All the colonizing MRSA isolates, excluding three, exhibited in their sensitivity tests the pattern expected for CA-MRSA with the majority of them sensitive to cotrimoxazole, clindamycin, minocycline, rifampin and quinolones. Interestingly tetracycline and fucidic acid were inactive in the majority of strains. 64 MRSA isolates were tested for Pantone Valentine Leukocidin and 36 (56.25%) were positive. In the multivariate analysis comparing MRSA-colonized to MSSA-colonized or non-colonized patients, independent predictors of MRSA colonization were: residence at long term care facility (LTCF) (P <0.001, OR 12.05) and the presence of skin disease (p<0.001, OR 3.06)Conclusion: Colonization with MRSA of patients admitted to the hospital is low and appears to reflect the prevalence of colonization with CA-MRSA in the community. Risk factors for MRSA acquisition do not include previous contact with health-care facilities but instead the presence of skin diseases (affecting skin integrity) and residence in long term care facility.

scholarly journals Risk factors for COVID-19 diagnosis, hospitalization, and subsequent all-cause mortality in Sweden: a nationwide study

2021 ◽  
Vol 36 (3) ◽  
pp. 287-298
Author(s):  
Jonathan Bergman ◽  
Marcel Ballin ◽  
Anna Nordström ◽  
Peter Nordström
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Long Term Care ◽  
Care Facility ◽  
Prescription Medication ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
All Cause Mortality

AbstractWe conducted a nationwide, registry-based study to investigate the importance of 34 potential risk factors for coronavirus disease 2019 (COVID-19) diagnosis, hospitalization (with or without intensive care unit [ICU] admission), and subsequent all-cause mortality. The study population comprised all COVID-19 cases confirmed in Sweden by mid-September 2020 (68,575 non-hospitalized, 2494 ICU hospitalized, and 13,589 non-ICU hospitalized) and 434,081 randomly sampled general-population controls. Older age was the strongest risk factor for hospitalization, although the odds of ICU hospitalization decreased after 60–69 years and, after controlling for other risk factors, the odds of non-ICU hospitalization showed no trend after 40–49 years. Residence in a long-term care facility was associated with non-ICU hospitalization. Male sex and the presence of at least one investigated comorbidity or prescription medication were associated with both ICU and non-ICU hospitalization. Three comorbidities associated with both ICU and non-ICU hospitalization were asthma, hypertension, and Down syndrome. History of cancer was not associated with COVID-19 hospitalization, but cancer in the past year was associated with non-ICU hospitalization, after controlling for other risk factors. Cardiovascular disease was weakly associated with non-ICU hospitalization for COVID-19, but not with ICU hospitalization, after adjustment for other risk factors. Excess mortality was observed in both hospitalized and non-hospitalized COVID-19 cases. These results confirm that severe COVID-19 is related to age, sex, and comorbidity in general. The study provides new evidence that hypertension, asthma, Down syndrome, and residence in a long-term care facility are associated with severe COVID-19.

scholarly journals Silencing and Silence: Language and Specialized Listening in a Long-Term Institution for the Elderly

2020 ◽  
pp. 1-9
Author(s):  
Simone Maximo Pelis ◽  
Nirvana Ferraz Santos Sampaio
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
The Elderly ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Methodological Perspective ◽  
Alternative System

This article presents the result of research developed with the language of elderly residents at the Long Term Care Facility for the Elderly - ILPI, in Vitória da Conquista, Bahia, Brazil. In response to the initial questions as to whether institutionalization affects the language of the elderly, whether the re-signification of verbal by non-verbal speech occurs, and whether silence, as language is part of an alternative system of possible meaning for the elderly, it was perceived that language in institutionalized long-lived individuals it reveals that in response to diversified processes of silencing, they have instituted silence as a possibility of reframing, and structuring of meaning. We collected data through the filming and recording of the elderly in enunciative-discursive situations, considering the uniqueness of each subject's history and their respective crossings as well as the condition of production of the narratives based on the concept of data-finding by Maria HadlerCoudry (1), aligned with notions relevant to Linguistics in the theoretical-methodological perspective of Discursive Neurolinguistics.

scholarly journals Risk factors for pneumonia and influenza hospitalizations in long-term care facility residents: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Patience Moyo ◽  
Andrew R. Zullo ◽  
Kevin W. McConeghy ◽  
Elliott Bosco ◽  
Robertus van Aalst ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

scholarly journals Risk factors for development of aminoglycoside resistance among gram-negative rods

2019 ◽  
Vol 76 (22) ◽  
pp. 1838-1847
Author(s):  
Stefan E Richter ◽  
Loren Miller ◽  
Jack Needleman ◽  
Daniel Z Uslan ◽  
Douglas Bell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Care Facility ◽  
Aminoglycoside Resistance ◽  
Term Care ◽  
Gram Negative ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
C Statistic

Abstract Purpose Development of scoring systems to predict the risk of aminoglycoside resistance and to guide therapy is described. Methods Infections due to aminoglycoside-resistant gram-negative rods (AR-GNRs) are increasingly common and associated with adverse outcomes; selection of effective initial antibiotic therapy is necessary to reduce adverse consequences and shorten length of stay. To determine risk factors for AR-GNR recovery from culture, cases of GNR infection among patients admitted to 2 institutions in a major academic hospital system during the period 2011–2016 were retrospectively analyzed. Gentamicin and tobramycin resistance (GTR-GNR) and amikacin resistance (AmR-GNR) patterns were analyzed separately. A total of 26,154 GNR isolates from 12,516 patients were analyzed, 6,699 of which were GTR, and 2,467 of which were AmR. Results In multivariate analysis, risk factors for GTR-GNR were presence of weight loss, admission from another medical or long-term care facility, a hemoglobin level of &lt;11 g/dL, receipt of any carbapenem in the prior 30 days, and receipt of any fluoroquinolone in the prior 30 days (C statistic, 0.63). Risk factors for AmR-GNR were diagnosis of cystic fibrosis, male gender, admission from another medical or long-term care facility, ventilation at any point prior to culture during the index hospitalization, receipt of any carbapenem in the prior 30 days, and receipt of any anti-MRSA agent in the prior 30 days (C statistic, 0.74). Multinomial and ordinal models demonstrated that the risk factors for the 2 resistance patterns differed significantly. Conclusion A scoring system derived from the developed risk prediction models can be applied by providers to guide empirical antimicrobial therapy for treatment of GNR infections.

Geriatric Teams in the Long-term Care Facility

1988 ◽  
Vol 1 (3) ◽  
pp. 195-201
Author(s):  
Ruthanne R. Ramsey
Keyword(s):  
Health Care ◽  
Long Term Care ◽  
Care Delivery ◽  
Care Facility ◽  
The Elderly ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Inpatient Settings

Geriatric teams have emerged as an accepted method of health care delivery to the elderly patient in ambulatory and acute inpatient settings. As one model of specialized health care teams, geriatric teams vary in structure, membership, and type. The purposes may be diverse, ranging from providing primary care to multidimensional functional and diagnostic assessment. Geriatric teams have convincingly demonstrated benefit to the care of the elderly. Overcoming significant barriers to their formation, geriatric teams are beginning to develop in long-term care facilities as a result of economic and educational pressures. However, the unique environment and needs of the long-term care facility have resulted in differences in leadership, membership, and structure of long-term care teams. Pharmacist involvement in the long-term care geriatric team could benefit the facility, patient care, and the profession. The key to future involvement by pharmacists in teams appears to depend on their interest, ability to acquire necessary skills, and demonstration of unique professional contributions.

A Norovirus Outbreak at a Long-Term-Care Facility: The Role of Environmental Surface Contamination

2005 ◽  
Vol 26 (10) ◽  
pp. 802-810 ◽  
Author(s):  
Henry M. Wu ◽  
Mary Fornek ◽  
Kellogg J. Schwab ◽  
Amy R. Chapin ◽  
Kristen Gibson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Care Facility ◽  
Rt Pcr ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Environmental Surface

AbstractBackground:The role of environmental surface contamination in the propagation of norovirus outbreaks is unclear. An outbreak of acute gastroenteritis was reported among residents of a 240-bed veterans long-term-care facility.Objectives:To identify the likely mode of transmission, to characterize risk factors for illness, and to evaluate for environmental contamination in this norovirus outbreak.Methods:An outbreak investigation was conducted to identify risk factors for illness among residents and employees. Stool and vomitus samples were tested for norovirus by reverse transcription polymerase chain reaction (RT-PCR). Fourteen days after outbreak detection, ongoing cases among the residents prompted environmental surface testing for norovirus by RT-PCR.Results:One hundred twenty-seven (52%) of 246 residents and 84 (46%) of 181 surveyed employees had gastroenteritis. Case-residents did not differ from non-case-residents by comorbidities, diet, room type, or level of mobility. Index cases were among the nursing staff. Eight of 11 resident stool or vomitus samples tested positive for genogroup II norovirus. The all-cause mortality rate during the month of the outbreak peak was significantly higher than the expected rate. Environmental surface swabs from case-resident rooms, a dining room table, and an elevator button used only by employees were positive for norovirus. Environmental and clinical norovirus sequences were identical.Conclusion:Extensive contamination of environmental surfaces may play a role in prolonged norovirus outbreaks and should be addressed in control interventions.

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