OBJECTIVES: To quantify the prevalence, risk factors, and mode of transmission associated with colonization by multidrug-resistant gram-negative bacteria (MDRGN) in the long-term care (LTC) setting. DESIGN: Cross-sectional. SETTING: Four nursing units in a 648-bed LTC facility in Boston, Massachusetts. PARTICIPANTS: Eighty-four long-term care residents. MEASUREMENTS: Nasal and rectal swabs were obtained to determine colonization with MDRGN; if present, molecular typing was performed. The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) was also determined. Demographic and clinical characteristics were obtained from the medical record. Multivariable analysis was used to identify factors independently associated with MDRGN colonization. RESULTS: A total of 51%, 28%, and 4% subjects were colonized with MDRGN, MRSA, and VRE, respectively. After multivariable adjustment, advanced dementia (adjusted odds ratio (AOR)=2.9, 95% confidence interval (CI)=1.2-7.35, P=.02) and nonambulatory status (AOR=5.7, 95% CI=1.1-28.9, P=.04) were the only independent risk factors for harboring MDRGN. Molecular typing indicated person-to-person transmission. CONCLUSION: Colonization with MDRGN is common in the LTC setting. A diagnosis of advanced dementia is a major risk factor for harboring MDRGN.
OBJECTIVES: To quantify the prevalence, risk factors, and mode of transmission associated with colonization by multidrug-resistant gram-negative bacteria (MDRGN) in the long-term care (LTC) setting. DESIGN: Cross-sectional. SETTING: Four nursing units in a 648-bed LTC facility in Boston, Massachusetts. PARTICIPANTS: Eighty-four long-term care residents. MEASUREMENTS: Nasal and rectal swabs were obtained to determine colonization with MDRGN; if present, molecular typing was performed. The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) was also determined. Demographic and clinical characteristics were obtained from the medical record. Multivariable analysis was used to identify factors independently associated with MDRGN colonization. RESULTS: A total of 51%, 28%, and 4% subjects were colonized with MDRGN, MRSA, and VRE, respectively. After multivariable adjustment, advanced dementia (adjusted odds ratio (AOR)=2.9, 95% confidence interval (CI)=1.2-7.35, P=.02) and nonambulatory status (AOR=5.7, 95% CI=1.1-28.9, P=.04) were the only independent risk factors for harboring MDRGN. Molecular typing indicated person-to-person transmission. CONCLUSION: Colonization with MDRGN is common in the LTC setting. A diagnosis of advanced dementia is a major risk factor for harboring MDRGN.
Authors: L Wang; B Lansing; K Symons; E L Flannery; J Fisch; K Cherian; S E McNamara; L Mody Journal: Eur J Clin Microbiol Infect Dis Date: 2012-01-25 Impact factor: 3.267
Authors: Rituparna Das; Virginia Towle; Peter H Van Ness; Manisha Juthani-Mehta Journal: Infect Control Hosp Epidemiol Date: 2010-11-22 Impact factor: 3.254
Authors: Jane L Givens; Sara Spinella; Claire K Ankuda; Erika D'Agata; Michele L Shaffer; Daniel Habtemariam; Susan L Mitchell Journal: J Am Geriatr Soc Date: 2015-06-01 Impact factor: 5.562
Authors: Alyssa B Dufour; Michele L Shaffer; Erika M C D'Agata; Daniel Habtemariam; Susan L Mitchell Journal: J Am Geriatr Soc Date: 2015-11-28 Impact factor: 5.562