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Prevalence of methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii in a long-term acute care
Jon P Furuno1, Joan N Hebden, Harold C Standiford
1Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA. jfuruno@epi.umaryland.edu
Background:
Patients in long-term acute care (LTAC) facilities often have many known risk factors for acquisition of antibiotic-resistant bacteria. However, the prevalence of resistance in these facilities has not been well described.
Methods:
We performed a single-day, point-prevalence study of a 180-bed, university-affiliated LTAC facility in Baltimore to assess the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii in the anterior nares, perirectal area, sputum, and wounds.
Results:
Among the 147 patients evaluated, we found a high prevalence of colonization by both MRSA (28%) and A baumannii (30%). Of the A baumannii isolates, 90% were susceptible to imipenem and 92% were susceptible to ampicillin-sulbactam. No isolates were resistant to both imipenem and ampicillin-sulbactam.
Conclusion:
The high prevalence of resistance found in this study supports the need for increased surveillance of patients in the LTAC environment. The fact that these patients are often frequently transferred to tertiary care facilities also supports the need for coordination and collaboration among facilities within the same health care system and the broader geographic area.
Insights
Long-term acute care facilities show high rates of antibiotic-resistant bacteria colonization. Increased surveillance and inter-facility collaboration are crucial for managing methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii.
Area of Science:
- Infectious Diseases
- Healthcare Epidemiology
- Antimicrobial Resistance
Background:
- Long-term acute care (LTAC) patients often have risk factors for antibiotic-resistant bacteria.
- Prevalence of antibiotic resistance in LTAC facilities is not well-documented.
Purpose of the Study:
- To assess the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii in an LTAC facility.
- To identify colonization rates in specific patient sites.
Main Methods:
- A single-day, point-prevalence study was conducted in a 180-bed university-affiliated LTAC facility.
- Samples collected from anterior nares, perirectal area, sputum, and wounds of 147 patients.
- Prevalence of MRSA and A. baumannii colonization was determined.
Main Results:
- High prevalence of MRSA (28%) and A. baumannii (30%) colonization was observed among 147 patients.
- 90% of A. baumannii isolates were susceptible to imipenem.
- 92% of A. baumannii isolates were susceptible to ampicillin-sulbactam; no isolates were resistant to both.
Conclusions:
- Findings highlight the need for enhanced surveillance of patients in LTAC settings.
- Frequent patient transfers necessitate coordinated efforts between LTAC and tertiary care facilities.
- Collaboration across healthcare systems and geographic areas is essential for resistance control.
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