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Proteeae groin skin carriage in ambulatory geriatric outpatients
N J Ehrenkranz1, D G Eckert, B C Alfonso
1Florida Consortium for Infection Control, Miami 33143.
Abstract:
Aerobic gram-negative bacillus (AGNB) groin skin carriage was prospectively studied in ambulatory geriatric outpatients: 42 from three nursing homes and 44 from private homes. Initially, 12 (28.6%) Proteeae carriers were in the former group and 3 (6.8%) were in the latter (P = 0.01). At one year, 6 of 7 surviving nursing home carriers remained Proteeae carriers while none from private homes remained carriers (P = 0.007). The annual prevalence of Proteeae carriage was 14 (33.3%) in nursing homes and 4 (9.1%) in private homes (P = 0.008); of non-Proteeae AGNB carriage, the annuyal prevalence was 2 (4.8%) and 4 (11.4%), respectively. Nursing home subjects had similar initial health characteristics; however, by one year, 5 of 12 carriers in contrast to 3 of 30 noncarriers were dead of chronic disease (P = 0.03). These nursing homes included persons with chronic diseases that apparently facilitated Proteeae carriage. Urethral catheters, skin ulcers, and recent antibiotics were not factors.
Insights
Geriatric outpatients in nursing homes showed significantly higher aerobic gram-negative bacillus (AGNB) carriage, particularly Proteeae. Chronic diseases in nursing home residents may facilitate this carriage.
Area of Science:
- Gerontology
- Infectious Diseases
- Microbiology
Background:
- Aerobic gram-negative bacilli (AGNB) are opportunistic pathogens.
- Skin carriage of AGNB can be a reservoir for infection.
- Geriatric populations, especially those in institutional settings, are susceptible to infections.
Purpose of the Study:
- To prospectively investigate aerobic gram-negative bacillus (AGNB) groin skin carriage in ambulatory geriatric outpatients.
- To compare carriage rates between nursing home residents and those living in private homes.
- To identify factors associated with AGNB carriage in this population.
Main Methods:
- Prospective study design.
- Recruitment of geriatric outpatients from nursing homes and private homes.
- Assessment of aerobic gram-negative bacillus (AGNB) groin skin carriage at baseline and one-year follow-up.
Main Results:
- Initial Proteeae carriage was significantly higher in nursing home residents (28.6%) compared to private home residents (6.8%).
- At one year, Proteeae carriage persisted in nursing home residents (33.3% annual prevalence) but not in private home residents (9.1%).
- Nursing home residents with Proteeae carriage had a higher mortality rate from chronic diseases (P=0.03).
Conclusions:
- Nursing home environments are associated with a higher prevalence of aerobic gram-negative bacillus (AGNB) groin skin carriage, particularly Proteeae.
- Chronic diseases prevalent in nursing home residents may contribute to facilitating Proteeae carriage.
- Urethral catheters, skin ulcers, and recent antibiotic use were not identified as contributing factors in this study.