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Published on: August 30, 2018
Low prevalence of colonization with multidrug-resistant gram-negative bacteria in long-term care facilities in Graz,
Eva Leitner1, Elisabeth Zechner2, Elisabeth Ullrich1
1Institute of Hygiene, Microbiology, and Environmental Medicine, Medical University of Graz, Graz, Austria.
Background:
Residents in long-term care facilities (LTCFs) are increasingly found to be an important reservoir of multidrug-resistant gram-negative (MRGN) bacteria.
Aims:
We aimed to determine colonization by MRGN bacteria over 6 months in LTCFs and geriatric wards in Graz, Austria, and to evaluate risk factors for such colonization.
Methods:
During August 2015, we conducted a point-prevalence survey at LTCFs and geriatric wards of the Geriatric Health Centers of the City of Graz. Inguinal and perianal swabs were taken from 137 patients and screened for MRGN using standard procedures. Six months after the initial investigation all colonized patients were sampled again and use of antibiotics, hospital admissions, and mortality was registered. Genetic relatedness of MRGN bacteria was evaluated.
Results:
We detected 12 patients harboring MRGN isolates (prevalence, 8.7%). Overall inguinal colonization was 5.1%. After 6 months, only 2 out of 12 patients were still colonized. Presence of a urinary catheter was associated with a higher risk of MRGN colonization (odds ratio [OR], 17.5; 95% CI, 1.6-192). Chronic wounds and gastrostomy were also risk factors of MRGN colonization (OR, 10.7; 95% CI, 1.6-69.3 and OR, 18.3; 95% CI, 2.4-139.4, respectively). There was no difference in mortality between colonized and noncolonized patients.
Conclusions:
Prevalence of colonization with MRGN bacteria was low in patients in LTCFs and geriatric wards in Graz, Austria.
Insights
Multidrug-resistant gram-negative (MRGN) bacteria colonization was low in Austrian long-term care facilities. Urinary catheters, chronic wounds, and gastrostomy were identified as risk factors for MRGN colonization.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Long-term care facilities (LTCFs) are significant reservoirs for multidrug-resistant gram-negative (MRGN) bacteria.
- Understanding MRGN colonization dynamics in LTCFs is crucial for infection control.
Purpose of the Study:
- To determine the prevalence of MRGN colonization over six months in Austrian LTCFs and geriatric wards.
- To identify risk factors associated with MRGN colonization in this population.
Main Methods:
- A point-prevalence survey was conducted in August 2015 at LTCFs and geriatric wards in Graz, Austria.
- Inguinal and perianal swabs were collected from 137 patients and screened for MRGN.
- Follow-up sampling at six months, along with registration of antibiotic use, hospital admissions, and mortality, was performed.
Main Results:
- The prevalence of MRGN colonization was 8.7% (12 patients), with inguinal colonization at 5.1%.
- After six months, only 2 of the 12 initially colonized patients remained colonized.
- Urinary catheter use (OR, 17.5), chronic wounds (OR, 10.7), and gastrostomy (OR, 18.3) were significant risk factors for MRGN colonization.
Conclusions:
- The prevalence of MRGN colonization in LTCFs and geriatric wards in Graz, Austria, was found to be low.
- Specific medical devices and conditions, such as urinary catheters, chronic wounds, and gastrostomy, increase the risk of MRGN colonization.
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