Prevalence of Multi-Resistant Microorganisms and Antibiotic Stewardship among Hospitalized Patients Living in Residential Care Homes in Spain: A Cross-Sectional Study

Abstract

Antimicrobial resistance is a growing global health problem. Patients living in care homes are a vulnerable high-risk population colonized by multidrug-resistant organisms (MDRO). We identified a case series of 116 residents of care homes from a cohort of 540 consecutive patients admitted to the internal medicine service of our hospital. We performed early diagnostic tests of MDRO through anal exudates in our sample. The prevalence of MDRO colonization was 34.5% of residents and 70% of them had not been previously identified in the clinical records. Previous hospitalizations and in-hospital antibiotic administration were significantly associated with the presence of MDRO. Our results emphasize the need to consider care homes in the planning of regional and national infection control measures and for implementing surveillance systems that monitor the spread of antimicrobial resistance in Spain. Systematic early testing upon admission to hospital services with a high prevalence of patients with MDRO colonization (e.g., internal medicine) could contribute to the adoption of adequate prevention measures. Specific educational programs for care home staff should also be implemented to address this increasing problem.

Prevalence and drug resistance patterns of Gram-negative enteric bacterial pathogens from diarrheic patients in Ethiopia: A systematic review and meta-analysis

“…It was also very close to the reports from India (66.12%) [87] and Egypt (65.5%) [88,89]. In contrast to our finding in Ethiopia, a lower prevalence of MDR has been reported from Germany (60%) [90], Nepal (42.6%) [91], Australia (36%) [92], Indonesia (28.7%) [93], the USA (27%) [94], Spain (34.5%) [95] and France (11.6%) [96]. Several factors may play a role in the difference including the magnitude and style of antimicrobial use and infection prevention practices.…”

How COVID-19 Has Influenced Public Interest in Antimicrobials, Antimicrobial Resistance and Related Preventive Measures: A Google Trends Analysis of Italian Data

“…This evidence suggests, on the one hand, that the WAAW does not contribute much to an increase in awareness of AMR and, on the other hand, that the COVID-19 pandemic may have had a negative impact. Thus, the COVID-19 pandemic could have contributed to reducing the information available, measures implemented, research conducted, and general interest in future pandemics in terms of the multi-drug-resistant infections, which are already plaguing several Mediterranean countries [25,26,[31][32][33][34]. For these reasons, there is a need for novel strategies to increase the interest of the general public and healthcare professionals, especially in countries where AMR rates are high.…”

OXA-48 Carbapenemase-Producing Enterobacterales in Spanish Hospitals: An Updated Comprehensive Review on a Rising Antimicrobial Resistance

“…In a previous study by our research group, we identified elderly patients living in residential care homes as a particularly vulnerable population for colonization by OXA-48 CRE [ 76 ]. Specifically, 34.5% of these patients showed positive rectal colonization by multiresistant bacteria, 27.5% of them by OXA-48-producing K. pneumoniae and 2.5% by OXA-48-producing E. coli .…”