Current prevalence of multidrug-resistant organisms in long-term care facilities in the Rhine-Main district, Germany,...

Area of Science:

• Infectious Diseases
• Healthcare Epidemiology
• Microbiology

Background:

• Multidrug-resistant organisms (MDRO), especially multidrug-resistant Gram-negative organisms (MRGN), pose a growing challenge in healthcare settings.
• Data on MDRO prevalence in long-term care facilities (LTCFs) are scarce, necessitating current prevalence assessments.

Purpose of the Study:

• To determine the prevalence of MDRO, including meticillin-resistant Staphylococcus aureus (MRSA), MRGN, and vancomycin-resistant enterococci (VRE), among residents in German LTCFs.
• To identify risk factors associated with MDRO carriage in this population.

Main Methods:

• A point prevalence survey was conducted in 2013 across 26 LTCFs in the German Rhine-Main region.
• Swabs (nose, throat, perineum) were analyzed for MRSA, and perianal swabs for ESBL-producing organisms, MRGN, and VRE.
• Data were collected from 690 residents for MRSA and 455 for rectal carriage of ESBL/MRGN and VRE.

Main Results:

• Prevalence rates were 6.5% for MRSA, 17.8% for ESBL/MRGN, and 0.4% for VRE.
• MRSA carriage was linked to prior MRSA infection, urinary catheters, feeding tubes, and antibiotic use.
• ESBL/MRGN carriage was exclusively associated with the presence of urinary catheters.

Conclusions:

• MRSA prevalence in German LTCFs has not increased since 2007.
• The prevalence of ESBL/MRGN carriage in LTCFs is notably high, with most cases previously undiagnosed.
• This highlights potential deficits in screening protocols and communication of patient status upon hospital discharge.