Patterns of Ciprofloxacin-Resistant Gram-Negative Bacteria Colonization in Nursing Home Residents

We evaluated the prevalence of colonization with all gram-negative bacilli (GNB) and with ciprofloxacin-resistant GNB among nursing home residents with and without indwelling devices. We found that device presence increases the risk of colonization with all GNB and with ciprofloxacin-resistant GNB. Colonization with ciprofloxacin-resistant GNB increases with decreasing functional status.

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Transmission of Resistant Gram-Negative Bacteria to Health Care Worker Gowns and Gloves during Care of Nursing Home Residents in Veterans Affairs Community Living Centers

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00790-17 ◽

2017 ◽

Vol 61 (10) ◽

Cited By ~ 6

Author(s):

Natalia Blanco ◽

Lisa Pineles ◽

Alison D. Lydecker ◽

J. Kristie Johnson ◽

John D. Sorkin ◽

...

Keyword(s):

Health Care ◽

Nursing Home ◽

High Risk ◽

Glucose Monitoring ◽

Nursing Home Residents ◽

Antibiotic Use ◽

Veterans Affairs ◽

Gram Negative Bacteria ◽

Gram Negative ◽

Multicenter Prospective Observational Study

ABSTRACT The objectives of the study were to estimate the risk of transmission of antibiotic-resistant Gram-negative bacteria (RGNB) to gowns and gloves (G&G) worn by health care workers (HCWs) when providing care to nursing home residents and to identify the types of care and resident characteristics associated with transmission. A multicenter, prospective observational study was conducted with residents and HCWs from Veterans Affairs (VA) nursing homes. Perianal swabs to detect RGNB were collected from residents. HCWs wore G&G during usual care activities, and the G&G were swabbed at the end of the interaction in a standardized manner. Transmission of RGNB from a colonized resident to G&G by type of care was measured. Odds ratios (ORs) associated with type of care or resident characteristics were estimated. Fifty-seven (31%) of 185 enrolled residents were colonized with ≥1 RGNB. RGNB transmission to HCW gloves or gowns occurred during 9% of the interactions (n = 905): 7% to only gloves and 2% to only gowns. Bathing the resident and providing hygiene and toilet assistance were associated with a high risk of transmission. Glucose monitoring and assistance with feeding or medication were associated with a low risk of transmission. In addition, antibiotic use by the resident was strongly associated with greater transmission (OR, 2.51; P < 0.01). RGNB were transferred to HCWs during ∼9% of visits. High-risk types of care were identified for which use of G&G may be prioritized. Antibiotic use was associated with 2.5 times greater risk of transmission, emphasizing the importance of antibiotic stewardship. (This study has been registered at ClinicalTrials.gov under registration no. NCT01350479.)

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Association between level of care and colonization with resistant gram-negative bacteria among nursing-home residents

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1274 ◽

2021 ◽

pp. 1-3

Author(s):

Timileyin Y Adediran ◽

Kinjal N Sethuraman ◽

Surbhi Leekha ◽

Mary-Claire Roghmann

Keyword(s):

Nursing Home ◽

Odds Ratio ◽

Nursing Home Residents ◽

Cross Sectional Study ◽

Level Of Care ◽

Gram Negative Bacteria ◽

Sectional Study ◽

Cross Sectional ◽

Gram Negative ◽

The Relationship

Abstract In this cross-sectional study, we examined the relationship between resident level of care in the nursing home and colonization with resistant gram-negative bacteria. Residential-care residents were more likely to be colonized with resistant gram-negative bacteria than were postacute care residents (odds ratio, 2.3; 95% confidence interval, 1.40–3.80; P < .001).

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Multidrug-Resistant Gram-Negative Bacteria: Inter- and Intradissemination Among Nursing Homes of Residents With Advanced Dementia

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2015.97 ◽

2015 ◽

Vol 36 (8) ◽

pp. 930-935 ◽

Cited By ~ 17

Author(s):

Erika M. C. D’Agata ◽

Daniel Habtemariam ◽

Susan Mitchell

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Risk Group ◽

Nursing Home Residents ◽

Multidrug Resistant ◽

High Risk Group ◽

Pulsed Field Gel Electrophoresis ◽

Gram Negative Bacteria ◽

Advanced Dementia ◽

Gram Negative

OBJECTIVETo quantify the extent of inter– and intra–nursing home transmission of multidrug-resistant gram-negative bacteria (MDRGN) among residents with advanced dementia and characterize MDRGN colonization among these residents.DESIGNProspective cohort study.SETTINGTwenty-two nursing homes in the greater Boston, Massachusetts, area.PATIENTSResidents with advanced dementia.METHODSSerial rectal surveillance cultures for MDRGN and resident characteristics were obtained every 3 months for 12 months or until death. Molecular typing of MDRGN isolates was performed by pulsed-field gel electrophoresis.RESULTSA total of 190 MDRGN isolates from 152 residents with advanced dementia were included in the analyses. Both intra– and inter–nursing home transmission were identified. Genetically related MDRGN strains, recovered from different residents, were detected in 18 (82%) of the 22 nursing homes. The percent of clonally related strains in these nursing homes ranged from 0% to 86% (average, 35%). More than 50% of strains were clonally related in 3 nursing homes. Co-colonization with more than 1 different MDRGN species occurred among 28 residents (18.4%). A total of 168 (88.4%), 20 (10.5%), and 2 (1.0%) of MDRGN isolates were resistant to 3, 4, and 5 different antimicrobials or antimicrobial classes, respectively.CONCLUSIONSMDRGN are spread both within and between nursing homes among residents with advanced dementia. Infection control interventions should begin to target this high-risk group of nursing home residents.Infect Control Hosp Epidemiol2015;36(8):930–935

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