Infections and antimicrobial use among institutionalized residents in Hungary: Increasing need of microbiological surveillance

Abstract

As a result of the age-related changes, more elders live in long-term care facilities (LTCFs). Due to their susceptibility, infections and excess use of antimicrobials are common. The aim was to estimate the burden of infections and antimicrobial use in Hungarian LTCFs in order to increase the attention given to the prevention. European-wide point prevalence survey was conducted between April and May 2013. For each resident who had a signs and symptoms of an infection and/or treated with an antibacterial for systemic use a resident questionnaire was completed. Descriptive statistics were used to present the data. In total, 91 LTCFs with 11,823 residents were selected in this survey. The 252 residents had a sign/symptom of an infection (2.1%) and 156 received antimicrobial (1.3%). Skin and soft tissues (36.5%) was the most frequent infection. However, antimicrobials were mostly prescribed for respiratory tract infections (40.4%). The most common therapeutic antimicrobial agent (97.5%) belonged to the quinolone antibacterials (34.2%). Our results emphasise the need for targeted improvement of antimicrobial use including: reducing the use of quinolone antibacterials in order to prevent the spread of Clostridium diffi cile and other antimicrobial resistant microorganisms among institutionalized residents.

Prevalence and impact of Clostridium difficile infection in elderly residents of long-term care facilities, 2011

“…It is not confined to LTCFs in USA but also extends in several geographic areas overseas, affecting the elderly and LTCF setting. [ 35 – 38 ] The adoption of prevention policies across the continuum of care is necessary in order to control the epidemic, but it is unlikely that antibiotic stewardship programs [ 39 , 40 ] and infection control policies will suffice to solve the problem across the healthcare system. [ 10 , 22 ] Moreover, bacteria can continue to adapt.…”

Plasmid-mediated quinolone resistance among extended spectrum beta lactase producing Enterobacteriaceae from bloodstream infections

“…Other data showed that ciprofloxacin MIC values may play a role in dissemination of major K. pneumoniae clones [34]. A study demonstrated the need for reduced FQ consumption to prevent the spread of antimicrobial resistant microorganisms among healthcare settings [35].…”

Clostridium difficile infection in hospitalized octogenarian patients

“…Older patients are unanimously recognized as a vulnerable, high‐risk population for CDI because they often have multiple comorbidities, and are more likely to have frequent and prolonged hospitalizations and to receive broad‐spectrum antibiotics, which disrupt intestinal microbiota . In addition, host defense against infections including C. difficile is altered in older patients by senescence of the immune mechanisms associated with aging .…”