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Published on: March 3, 2023
Prevalence of Multidrug-Resistant Organisms and Risk Factors for Carriage among Patients Transferred from Long-Term
Hyeongseok Jeong1, Seonghui Kang2, Hyun Jung Cho3
1Division of Infectious Disease, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea. grinus@gmail.com.
Background:
Patient transport between acute care hospitals and long-term care facilities (LTCFs) plays a significant role in microbial migration. The study aimed to estimate the prevalence and risk factors associated with the colonization of multidrug-resistant organisms (MDROs) among patients transferred from LTCFs.
Materials And Methods:
We retrospectively reviewed medical records to examine the colonization of MDROs. All patients who were transferred from LTCFs and admitted to an acute care hospital with 800 beds in Daejeon between March 2018 and February 2019 were included in the study. We surveyed rectal cultures and nasal swabs obtained for screening vancomycin-resistant Enterococcus (VRE), carbapenem-resistant Enterobacteriaceae (CRE), and methicillin-resistant Staphylococcus aureus (MRSA) at the time of hospitalization. We conducted a multivariable logistic regression to assess the association between clinical variables and the carriage of MDROs.
Results:
Four hundred and fifteen patients from 86 LTCFs were enrolled. A total of 31.1% (130/415) of participants carried MDROs; VRE colonization was detected in 17.1% (71/415) of participants, and MRSA colonization was shown in 19.5% (81/415) of participants. No CRE was isolated. Previous use of antibiotics within three months [odds ratio (OR) 2.28; (95% confidence interval (CI) 1.30 - 4.00), P = 0.004], use of antibiotics for longer than two weeks [OR 2.16; (95% CI 1.03 - 4.53), P = 0.040], and previous colonization of MDROs within one year [OR 2.01; (95% CI 1.15 - 3.54), P = 0.015] were independently associated with increased risk for carriage of MDROs.
Conclusion:
Our study showed that a third of patients transferred from LTCFs carried VRE or MRSA, and prior antibiotic therapy was highly associated with the carriage of MDROs, which suggested more efficient management approaches for high-risk patients.
Insights
A third of patients transferred from long-term care facilities carried multidrug-resistant organisms (MDROs), primarily VRE and MRSA. Prior antibiotic use significantly increased the risk of MDRO colonization, highlighting the need for targeted management strategies.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Patient transfers between acute care hospitals and long-term care facilities (LTCFs) facilitate microbial spread.
- Understanding the prevalence and risk factors of multidrug-resistant organism (MDRO) colonization in this population is crucial for infection control.
Purpose of the Study:
- To estimate the prevalence of MDRO colonization in patients transferred from LTCFs to acute care hospitals.
- To identify clinical risk factors associated with MDRO carriage in this patient group.
Main Methods:
- Retrospective review of medical records for patients transferred from LTCFs between March 2018 and February 2019.
- Screening for vancomycin-resistant Enterococcus (VRE), carbapenem-resistant Enterobacteriaceae (CRE), and methicillin-resistant Staphylococcus aureus (MRSA) using rectal cultures and nasal swabs.
- Multivariable logistic regression analysis to determine associations between clinical variables and MDRO carriage.
Main Results:
- Out of 415 patients from 86 LTCFs, 31.1% were colonized with MDROs.
- VRE colonization was found in 17.1% and MRSA in 19.5%; no CRE was detected.
- Independent risk factors for MDRO carriage included prior antibiotic use within three months (OR 2.28), antibiotic therapy exceeding two weeks (OR 2.16), and previous MDRO colonization within one year (OR 2.01).
Conclusions:
- Approximately one-third of patients transferred from LTCFs carried VRE or MRSA.
- Previous antibiotic exposure is a significant risk factor for MDRO carriage.
- Findings suggest a need for enhanced management strategies for high-risk patients to mitigate MDRO transmission.
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