Colonization by multidrug-resistant organisms in long-term care facilities in Italy: a point-prevalence study

Area of Science:

• Infectious Diseases
• Epidemiology
• Microbiology

Background:

• Long-term care facilities (LTCFs) are recognized as reservoirs for multidrug-resistant organisms (MDROs).
• Understanding the prevalence and risk factors for MDRO colonization in LTCF residents is crucial for infection control.
• Limited data exists on MDRO colonization in Italian LTCFs.

Purpose of the Study:

• To determine the prevalence of key MDROs in Italian LTCF residents.
• To identify risk factors associated with MDRO colonization.
• To investigate the genotypes of MDRO isolates.

Main Methods:

• A point-prevalence study was conducted across 12 LTCFs in four Italian cities.
• Rectal swabs, faeces, and nasal/auxiliary swabs were cultured for specific MDROs.
• Antimicrobial susceptibility testing, gene detection, and molecular typing were performed. Risk factor analysis utilized univariate and multivariate methods.

Main Results:

• The prevalence of colonization was 57.3% for extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, 17.2% for methicillin-resistant Staphylococcus aureus (MRSA), and 5.1% for Clostridium difficile.
• Carriage of carbapenemase-producing Enterobacteriaceae was 1%.
• Being bedridden was a common independent risk factor for all MDROs, with specific risk factors identified for each organism. Molecular typing revealed common and unique MDRO strains.

Conclusions:

• Multidrug-resistant organism colonization is highly prevalent among residents in Italian LTCFs.
• Targeted infection control strategies are needed within LTCFs to mitigate MDRO transmission.
• Further research into specific transmission dynamics within and between facilities is warranted.