Inguinal skin colonization with multidrug-resistant bacteria among residents of elderly care facilities: Frequency, persistence, molecular analysis and clinical impact

Ruscher, Claudia; Pfeifer, Yvonne; Layer, Franziska; Schaumann, Reiner; Levin, Katja; Mielke, Martin

doi:10.1016/j.ijmm.2014.08.006

Cited by 22 publications

(20 citation statements)

References 45 publications

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“…In our study, patients aged above 60 years represented the highest proportion of patients with MDR bacterial infections, followed by middle-aged patients (40-59 years), and infants (<2 years). Elderly patients are generally consider to be at high risk of nosocomial infections, due to a higher disease prevalence in this population, including neurological disorders, diabetes and cardiovascular diseases [21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Analysis of multidrug-resistant bacteria in 3223 patients with hospital-acquired infections (HAI) from a tertiary general hospital in China

Wang¹,

H²,

Zhao

et al. 2019

Bosn J of Basic Med Sci

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The frequency of antimicrobial resistance has increased globally due to misuse and overuse of antibiotics, and multi-drug resistant (MDR) bacteria are now recognized as a major cause of hospital-acquired infections (HAI). Our aim was to investigate the prevalence, distribution, and antimicrobial susceptibility rates of MDR bacteria in patients with HAI from a tertiary hospital in China. We retrospectively evaluated all patients with a confirmed diagnosis of bacterial infection at a tertiary general hospital in Jining, for the period between January 2012 and December 2014. The following clinical and demographic data were collected: age, sex, specimens, treatment, microbiology results, and antibiotic resistance patterns of isolates. Bacterial identification and susceptibility testing were performed using VITEK 2 COMPACT system. We screened a total of 15,588 patients, out of which 7579 (48.6%) had an HAI. MDR showed 3223 out of 7579 isolates (42.5%). The most frequently isolated MDR bacteria in patients with HAI were extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (n = 1216/3223, 37.7%), MDR Pseudomonas aeruginosa (n = 627/3223, 19.5%) and MDR Acinetobacter baumannii (n = 588/3223, 18.2%). MDR-HAI were more common in males (2074/3223, 64.4%) and in elderly patients (≥60 years; 1196/3223, 37.1%). Sputum was the main source of MDR isolates (2056/3223, 63.8%). Patients with MDR-HAI were predominantly distributed in different types of intensive care units. MDR strains in our study showed resistance to most current antibiotics. Overall, patients with HAI infections attributed to MDR bacteria were widely distributed in our hospital. Enhanced surveillance of MDR bacteria is critical for guiding the rational use of antibiotics and reducing the incidence of HAI.

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Section: Discussionmentioning

confidence: 99%

Analysis of multidrug-resistant bacteria in 3223 patients with hospital-acquired infections (HAI) from a tertiary general hospital in China

Wang¹,

H²,

Zhao

et al. 2019

Bosn J of Basic Med Sci

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“…MDR colonization significantly increases the risk of MDR infection, with relative risks ranging from 3 to 26 [5, 53–58]. Ruscher et al [59] recently found that most MRSA and MDR-GNB persistently colonized residents up to six months or more. Notably, in many cases infections tend to occur more often in residents colonized by resistant pathogens.…”

Section: Public Health Importance and The Prognostic Role Of Colonizamentioning

confidence: 99%

Colonization with Multidrug-Resistant Organisms in Nursing Homes: Scope, Importance, and Management

Cassone

Mody

2015

Curr Geri Rep

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Bacterial infections are among the most common causes of morbidity and mortality in Nursing Homes (NH) and other long term care facilities. Multi-drug resistant organisms (MDROs) represent an ever-increasing share of causative agents of infection, and their prevalence in NHs is now just as high as in acute-care facilities, or even higher. Indeed, NHs are now considered a major reservoir of MDROs for the community at large. Asymptomatic colonization is usually a prerequisite to development of symptomatic infection. While progress has been made in defining epidemiology of MDROs in NHs, few studies have evaluated the role of changing healthcare delivery in introducing and further transmitting MDROs in this setting. Furthermore, the factors influencing the spread of colonization and the key prognostic indicators leading to symptomatic infections in the burgeoning short stay population need to be explored further. The difficulty of this task lies in the heterogeneity of NHs in terms of focus of care, organization and resources, and on the diversity among the many MDRO species encountered, which harbor different resistance genes and with a different prevalence depending on the geographic location, local antimicrobial pressure and residents risk factors such as use of indwelling devices, functional disability, wounds and other comorbidities. We present literature findings on the scope and importance of colonization as a pathway to infection with MDROs in NHs, underline important open questions that need further research, and discuss the strength of the evidence for current and proposed screening, prevention, and management interventions.

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“…This finding was comparable with prior literature that found a low prevalence of VRE skin colonization that ranged from 0% to 2.7% in two long-term care facilities located in Germany and Italy, respectively. 16,17 A potential explanation may be that perianal and/or rectal colonization is a better environment for isolating VRE. However, VRE infections are not as significant of a problem in the Latin American region (3.0%) as compared with the United States (9.9%).…”

Section: Discussionmentioning

confidence: 99%

Multidrug-Resistant Microorganisms Colonizing Lower Extremity Wounds in Patients in a Tertiary Care Hospital, Lima, Peru

Mendo-Lopez

Jasso

Linares

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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Multidrug-resistant organism (MDRO) infections cause high morbidity and mortality, and high costs to patients and hospitals. The study aims were to determine the frequency of MDRO colonization and associated factors in patients with lower-extremity wounds with colonization. A cross-sectional study was designed during November 2015 to July 2016 in a tertiary care hospital in Lima, Peru. A wound swab was obtained for culture and susceptibility testing. MDRO colonization was defined if the culture grew with methicillin-resistant , vancomycin-resistant enterococci, and/or extended spectrum beta-lactamase (ESBL) microorganisms. The frequency of MDRO wound colonization was 26.8% among the 97 patients enrolled. The most frequent MDRO obtained was ESBL-producing, which was significantly more frequent in chronic wounds versus acute wounds (17.2% versus 0%, < 0.05). Infection control measures should be implemented when patients with chronic lower-extremity wounds are admitted.

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Inguinal skin colonization with multidrug-resistant bacteria among residents of elderly care facilities: Frequency, persistence, molecular analysis and clinical impact

Cited by 22 publications

References 45 publications

Analysis of multidrug-resistant bacteria in 3223 patients with hospital-acquired infections (HAI) from a tertiary general hospital in China

Analysis of multidrug-resistant bacteria in 3223 patients with hospital-acquired infections (HAI) from a tertiary general hospital in China

Colonization with Multidrug-Resistant Organisms in Nursing Homes: Scope, Importance, and Management

Multidrug-Resistant Microorganisms Colonizing Lower Extremity Wounds in Patients in a Tertiary Care Hospital, Lima, Peru

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