Kevin Heinze1, Mohammed Kabeto2, Emily Toth Martin3, Marco Cassone2, Liam Hicks3, Lona Mody4. 1. University of Michigan Medical School, Ann Arbor, MI. Electronic address: kheinze@umich.edu. 2. Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, MI. 3. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI. 4. Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, MI; Geriatrics Research Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI.
Abstract
BACKGROUND: The emergence of vancomycin-resistant Staphylococcus aureus (VRSA) poses significant challenges for antibiotic therapy. We characterized the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) co-colonization that may facilitate resistance transfer and vancomycin-resistant S aureus emergence among nursing facility patients. METHODS: We cultured newly admitted patient hands, nares, oropharynx, groin, and perianal region plus wounds and device insertion sites, if applicable, upon enrollment at day 14, day 30, and monthly follow-up up to 6 months. Demographic, comorbidity, and antimicrobial use data were collected. Functional status was assessed at each visit using the Physical Self-Maintenance Scale. Multinomial logistic regression was performed to determine factors predictive of co-colonization. RESULTS: Five hundred eight patients were enrolled, with an average follow-up time of 28.5days. Prevalence of MRSA/VRE co-colonization, MRSA alone, and VRE alone was 8.7%, 8.9%, and 23.4%, respectively. Independent predictors of co-colonization included indwelling device use (odds ratio [OR] = 5.5 [2.2-13.7]), recent antibiotic use (OR = 2.5 [1.4-4.2]), diabetes (OR = 1.9 [1.0-3.8]), and the presence of open wounds (OR = 1.9 [1.0-3.6]). CONCLUSIONS: High rates of VRE are driving co-colonization with MRSA in nursing facilities. Indwelling device use, recent antibiotic use, diabetes, and open wounds predicted patient co-colonization.
BACKGROUND: The emergence of vancomycin-resistant Staphylococcus aureus (VRSA) poses significant challenges for antibiotic therapy. We characterized the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) co-colonization that may facilitate resistance transfer and vancomycin-resistant S aureus emergence among nursing facility patients. METHODS: We cultured newly admitted patient hands, nares, oropharynx, groin, and perianal region plus wounds and device insertion sites, if applicable, upon enrollment at day 14, day 30, and monthly follow-up up to 6 months. Demographic, comorbidity, and antimicrobial use data were collected. Functional status was assessed at each visit using the Physical Self-Maintenance Scale. Multinomial logistic regression was performed to determine factors predictive of co-colonization. RESULTS: Five hundred eight patients were enrolled, with an average follow-up time of 28.5days. Prevalence of MRSA/VRE co-colonization, MRSA alone, and VRE alone was 8.7%, 8.9%, and 23.4%, respectively. Independent predictors of co-colonization included indwelling device use (odds ratio [OR] = 5.5 [2.2-13.7]), recent antibiotic use (OR = 2.5 [1.4-4.2]), diabetes (OR = 1.9 [1.0-3.8]), and the presence of open wounds (OR = 1.9 [1.0-3.6]). CONCLUSIONS: High rates of VRE are driving co-colonization with MRSA in nursing facilities. Indwelling device use, recent antibiotic use, diabetes, and open wounds predicted patient co-colonization.
Authors: Catharina Matheï; Luc Niclaes; Carl Suetens; Béatrice Jans; Frank Buntinx Journal: Infect Dis Clin North Am Date: 2007-09 Impact factor: 5.982
Authors: M Papadimitriou-Olivgeris; E Drougka; F Fligou; F Kolonitsiou; A Liakopoulos; V Dodou; E D Anastassiou; E Petinaki; M Marangos; K S Filos; I Spiliopoulou Journal: Infection Date: 2014-08-21 Impact factor: 3.553
Authors: James A McKinnell; Loren G Miller; Raveena Singh; Ken Kleinman; Ellena M Peterson; Kaye D Evans; Tabitha D Dutciuc; Lauren Heim; Adrijana Gombosev; Marlene Estevez; Bryn Launer; Tom Tjoa; Steven Tam; Michael A Bolaris; Susan S Huang Journal: Infect Control Hosp Epidemiol Date: 2016-09-27 Impact factor: 3.254
Authors: Evonne Koo; Sara McNamara; Bonnie Lansing; Russell N Olmsted; Ruth Anne Rye; Thomas Fitzgerald; Lona Mody Journal: Am J Infect Control Date: 2016-08-20 Impact factor: 2.918
Authors: Katherine Reyes; Rushdah Malik; Carol Moore; Susan Donabedian; Mary Perri; Laura Johnson; Marcus Zervos Journal: J Clin Microbiol Date: 2009-12-09 Impact factor: 5.948
Authors: Aluem Tark; Leah V Estrada; Mary E Tresgallo; Denise D Quigley; Patricia W Stone; Mansi Agarwal Journal: Palliat Med Date: 2020-03-10 Impact factor: 4.762