Multidrug-resistant Bacteria Colonization Amongst Patients Newly Admitted to a Geriatric Unit: A Prospective Cohort Study

J Infect. 2012 Aug;65(2):109-18. doi: 10.1016/j.jinf.2012.02.004. Epub 2012 Feb 14.

Abstract

Objectives: To determine prevalence, incidence and risk factors of colonization by extended-spectrum β-lactamase-producing Enterobacteriacae (ESBLE), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus (VRE) in aged subjects admitted to an acute geriatric unit at a teaching hospital.

Methods: During 12 months, 337 patients were screened by nasal, oropharyngeal, groin, axillary and rectal swabs upon admission and at discharge.

Results: The prevalence of ESBLE, MRSA and VRE carriage upon admission was 11.6%, 7.5% and 0.6%, respectively. The incidence density of ESBLE and MRSA carriage was respectively of 1.77 and 2.40 new cases for 1000 patient-days. No cases of VRE acquisition were found. Risk factors for ESBLE colonization on admission were: multiple contacts with the hospital within the previous year, chronic catheter use and a high level of dependency. For MRSA, risk factors were: chronic wounds, anti-acid use and a high level of dependency.

Conclusion: This study shows a high prevalence of asymptomatic colonization of ESBL-producing Escherichia coli in patients admitted to an acute geriatric ward, as high as MRSA carriage. A low functional status is a common risk factor both for ESBLE and for MRSA colonization and it highlights the need to reinforce infection control measures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology*
  • Axilla / microbiology
  • Bacteria / classification
  • Bacteria / drug effects*
  • Bacteria / isolation & purification
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / microbiology
  • Carrier State / epidemiology*
  • Carrier State / microbiology
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Drug Resistance, Multiple, Bacterial*
  • Female
  • Groin / microbiology
  • Hospitals
  • Humans
  • Incidence
  • Male
  • Nose / microbiology
  • Oropharynx / microbiology
  • Prevalence
  • Prospective Studies
  • Rectum / microbiology
  • Risk Factors

Substances

  • Anti-Bacterial Agents