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Updated: May 1, 2026
Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
Published on: March 3, 2023
Prevalence of multidrug-resistant organisms and risk factors for carriage in long-term care facilities: a nested
Ching Jou Lim1, Allen C Cheng2, Jacqueline Kennon3
1Centre for Medicine Use and Safety, Monash University, Melbourne, Victoria, Australia.
Background:
Long-term care facilities (LTCFs) are a potentially important reservoir of multidrug-resistant (MDR) organisms; however, limited data exist.
Methods:
A point-prevalence study was conducted in four co-located LTCFs in Australia. Nasal and rectal swabs were cultured for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and MDR Gram-negative bacilli (GNB). Molecular typing and resistance detection were performed. Risk factors for colonization with an MDR organism were determined using a nested case-control study.
Results:
Consent was obtained from 115 (85%) of 136 eligible participants. Forty-one (36%) residents carried at least one type of MDR organism. The prevalence was 16% MRSA (n = 18), 6% VRE (n = 7) and 21% MDR GNB [n = 24; including extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (n = 12) and Acinetobacter baumannii (n = 6)]. The majority of ESBL-producing E. coli and A. baumannii were clonal. Current wound management [adjusted OR (AOR) 8.81 (95% CI 2.78-27.94), P < 0.001], medical device in situ [AOR 5.58 (95% CI 1.34-23.32), P = 0.018] and pressure ulcer [AOR 3.69 (95% CI 1.06-12.86), P = 0.04] were independent risk factors for MDR organism colonization. Advanced dementia [AOR 3.54 (95% CI 1.23-10.23), P = 0.02] and prolonged antibiotic use [AOR 2.95 (95% CI 1.01-8.60), P = 0.047] were independently associated with MRSA colonization, whilst current wound management [AOR 15.59 (95% CI 4.85-50.10), P < 0.001] and fluoroquinolone use [AOR 4.27 (95% CI 1.20-15.25), P = 0.025] were risk factors for MDR GNB colonization.
Conclusions:
LTCFs are an important reservoir of MDR organisms, with person-to-person transmissions being a potential issue. We have identified several predictors of colonization with MDR organisms, allowing a more targeted management of high-risk residents.
Insights
Long-term care facilities (LTCFs) are significant reservoirs for multidrug-resistant (MDR) organisms. Identifying colonization predictors like wound care and antibiotic use aids targeted management of high-risk residents.
Area of Science:
- Infectious Diseases
- Epidemiology
- Microbiology
Background:
- Long-term care facilities (LTCFs) are potential reservoirs for multidrug-resistant (MDR) organisms, but data are limited.
- Understanding MDR organism prevalence and transmission in LTCFs is crucial for infection control.
Purpose of the Study:
- To determine the prevalence of key MDR organisms in Australian LTCFs.
- To identify risk factors associated with MDR organism colonization in LTCF residents.
Main Methods:
- A point-prevalence study was conducted in four co-located Australian LTCFs.
- Nasal and rectal swabs were cultured for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and MDR Gram-negative bacilli (GNB).
- A nested case-control study identified risk factors for MDR organism colonization.
Main Results:
- 36% of residents carried at least one MDR organism: 16% MRSA, 6% VRE, and 21% MDR GNB (including ESBL-producing E. coli and A. baumannii).
- Independent risk factors for MDR organism colonization included wound management, indwelling medical devices, and pressure ulcers.
- Advanced dementia and prolonged antibiotic use were associated with MRSA, while wound management and fluoroquinolone use were linked to MDR GNB.
Conclusions:
- LTCFs serve as important reservoirs for MDR organisms, with potential for person-to-person transmission.
- Identified predictors of MDR organism colonization enable targeted management strategies for high-risk residents in LTCFs.
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