Colonization of long-term care facility residents in three Italian Provinces by multidrug-resistant bacteria

Objective.To investigateAcinetobacter baumanniiinfection, colonization, and transmission related to a long-term care facility (LTCF) providing subacute care (facility A).Methods.We reviewed facility A and affiliated local hospital records for facility A residents withA. baumanniiisolated during the period January 2009 through February 2010 and comparedA. baumanniiantimicrobial resistance patterns of residents with those of hospital patients. During March 2010, we implemented a colonization survey of facility A residents who received respiratory support or who could provide sputum samples and looked forA. baumanniicolonization risks. Available clinical and survey isolates underwent pulsed-field gel electrophoresis (PFGE); PFGE strains were linked with overlapping stays to identify possible transmission.Results.During the period January 2009 through February 2010, 33 facility A residents hadA. baumanniiisolates; all strains were multidrug resistant (MDR), which was a significantly higher prevalence of MDR strains than that found among isolates from hospital patients (81 [66%] of 122 hospital patient isolates were MDR;P< .001). The sputum survey found that 14 (20%) of 70 residents hadA. baumanniicolonization, which was associated with ventilator use (adjusted odds ratio, 4.24 [95% confidence interval, 1.06–16.93]); 12 (86%) of 14 isolates were MDR. Four facility A resident groups clustered with 3 PFGE strains and overlapping stays. One of these facility A residents also clustered with 3 patients at an affiliated hospital.Conclusions.We documented substantial MDRA. baumanniiinfections and colonization with probable intra- and interfacility spread associated with a single LTCF providing subacute care. Given the limited infection prevention and antimicrobial stewardship resources in such settings, regional collaborations among facilities across the spectrum of health care are needed to address this MDR threat.

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Evaluation of Remel Spectra CRE Agar for Detection of Carbapenem-Resistant Bacteria from Rectal Swabs Obtained from Residents of a Long-Term-Care Facility

Journal of Clinical Microbiology ◽

10.1128/jcm.00789-15 ◽

2015 ◽

Vol 53 (9) ◽

pp. 2823-2826 ◽

Cited By ~ 7

Author(s):

Vincent J. LaBombardi ◽

Carl M. Urban ◽

Barry N. Kreiswirth ◽

Liang Chen ◽

Giuliana Osorio ◽

...

Keyword(s):

Long Term Care ◽

Agar Plate ◽

Care Facility ◽

Resistant Bacteria ◽

Term Care ◽

Content Type ◽

Term Care Facility ◽

Long Term Care Facility ◽

Carbapenem Resistant

We compared the Remel Spectra CRE agar plate to CDC standard methodology for the isolation of carbapenem-resistantEnterobacteriaceae(CRE) from 300 rectal swab specimens obtained from patients residing in a long-term-care facility (LTCF). Multiplex PCR experiments were performed on isolates to identify specificKlebsiella pneumoniaecarbapenemases (KPC) and additional β-lactamases. Of the 300 patients, 72 (24%) harbored CRE and were PCR positive for KPC enzymes. The Remel Spectra CRE plates detected KPC-type CRE in isolates from 70 of 72 patients (97.2%), while the CDC method detected CRE in 56 of 72 (77.8%). CRE identification results were available in 18 h compared to 36 h for the CDC method. Remel Spectra CRE agar plates can provide useful means for a fast and reliable method for detecting KPC-type CRE and for accelerated institution of appropriate infection control precautions.

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Infection Prevention and Control in the Long-Term-Care Facility

Infection Control and Hospital Epidemiology ◽

10.1017/s0195941700086562 ◽

1997 ◽

Vol 18 (12) ◽

pp. 831-849 ◽

Cited By ~ 45

Author(s):

Philip W. Smith ◽

Patricia G. Rusnak

Keyword(s):

Infection Control ◽

Long Term Care ◽

Care Facility ◽

Infection Prevention And Control ◽

Resistant Bacteria ◽

Term Care ◽

Term Care Facility ◽

Long Term Care Facility ◽

Control Programs

AbstractMore than 1.5 million residents reside in US nursing homes. In recent years, the acuity of illness of nursing home residents has increased. Long-term-care facility residents have a risk of developing nosocomial infection that is similar to acute-care hospital patients. A great deal of information has been published concerning infections in the long-term-care facility, and infection control programs are nearly universal.This position paper reviews the literature on infections and infection control programs in the long-term-care facility, covering such topics as tuberculosis, bloodborne pathogens, epidemics, isolation systems, immunization, and antibiotic-resistant bacteria. Recommendations are developed for long-term-care infection control programs based on interpretation of currently available evidence. The recommendations cover the structure and function of the infection control program, including surveillance, isolation, outbreak control, resident care, and employee health. Infection control resources also are presented.

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