Active surveillance for carbapenem-resistant Enterobacteriaceae, vancomycin-resistant enterococci and toxigenic Clostridium difficile among patients transferred from long-term care facilities in Korea

Hwang, Joo-Hee; Park, Jeong Su; Lee, Eunyoung; Bae, Jae‐Young; Song, Kyoung-Ho; Choe, Pyoeng Gyun; Park, Wan Beom; Bang, Ji Hwan; Kim, Eu Suk; Park, Sang Won; Kim, Nam Joong; Oh, Myoung‐don; Kim, Hong Bin

doi:10.1016/j.jhin.2018.02.017

Cited by 11 publications

(14 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our observed prevalence among patients transferred from LTCFs was about 31.3%, which was generally in the range of previous data. The previous study conducted at an ACH in Korea showed 20.9% of VRE colonization among patients from LTCFs [18], which is similar to our rate. Notably, we observed no colonization of CRE.…”

Section: Discussionsupporting

confidence: 91%

“…Studies carried out at ACHs also found that patients admitted from LTCFs had higher odds of colonization [14]. Exposure to antibiotics was found to be a risk factor for colonization of VRE in the rectum [18], and previous colonization of multidrug-resistant Gram-negative bacteria was the single risk factor [19] among patients transferred from LTCFs. Interestingly, a stay in an LTCF for longer than one year was revealed to be a protective factor for the carriage of VRE (subgroup 1, Supplementary Table 1), since residency in long-term care facilities may provide an opportunity for the person to person transmission of microorganisms.…”

Section: Discussionmentioning

confidence: 89%

“…Notably, we observed no colonization of CRE. The previous survey also showed a low rate of CRE colonization among patients from LTCFs [18]; thus, we questioned the cost-effectiveness of screening culture for CRE among patients transferred from LTCFs. The early detection of asymptomatic carriers is essential for successful control of nosocomial spreading, and the colonization of MDROs will vary widely due to risk factors, resident populations, staff to patient ratios, and especially the local antibiotic resistance epidemiology [3,14,15,24].…”

Section: Discussionmentioning

confidence: 95%

“…The point prevalence of MDROs and risk factors of carriage among patients, environmental surfaces, and hands and clothing of healthcare workers in various LTCFs were evaluated [3,5,7,8,10,[15][16][17]. However, studies are limited in Korea, and the actual prevalence remains unclear [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prevalence of Multidrug-Resistant Organisms and Risk Factors for Carriage among Patients Transferred from Long-Term Care Facilities

2020

View full text Add to dashboard Cite

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 vancomycinresistant Enterococcus (VRE), carbapenem-resistant Enterobacteriaceae (CRE), and methicillinresistant 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.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of Multidrug-Resistant Organisms and Risk Factors for Carriage among Patients Transferred from Long-Term Care Facilities

2020

View full text Add to dashboard Cite

show abstract

“…In addition, none of them were CPE positive. 27 Consequently, it is thought that screening all patients transferred from LTCFs is ineffective in terms of cost-effectiveness. The results of our study show that there was a high proportion of CPE colonized LTCFs patients who may potentially be hospitalized in acute care hospitals.…”

Section: Discussionmentioning

confidence: 99%

Positivity of Carbapenemase-producing Enterobacteriaceae in Patients Following Exposure within Long-term Care Facilities in Seoul, Korea

et al. 2020

View full text Add to dashboard Cite

Background Carbapenemase-producing Enterobacteriaceae (CPE) are emerging as a worldwide threat. Long-term care facilities (LTCFs) are considered a reservoir for CPE and play a central role in transmission to acute care hospitals. We investigated the CPE positivity in patients exposed to CPE in LTCFs. Furthermore, we analyzed the CPE positivity rates in the environment exposed to CPE. Methods We collected rectal swab specimens from patients residing in LTCFs who were exposed to CPE. Environmental sampling was performed by infection control practitioners from sites classified as patient private space, common space in the patient room, common space other than patient rooms, and nursing station. Each sample was cultured on a Chrom Klebsiella pneumoniae carbapenemase (KPC) agar for CPE screening. The positive isolates were subjected to a polymerase chain reaction to identify the presence of bla KPC , bla VIM , bla IMP , bla OXA-48 , and bla NDM and determine CPE genotype. Results From 65 index cases, a total of 24 hospitals and 481 patients were enrolled; 414 patients who had resided in the same patient room as a patient with confirmed CPE and 67 patients who were newly admitted to that patient room. A total of 117 (24.3%) patients were positive for CPE among which 93 (22.5%, 93/414) were already admitted patients and 24 (35.8%, 24/67) were newly admitted patients. A total of 163 CPEs were detected and K. pneumoniae (n = 104, 63.8%) was the most common bacteria followed by Escherichia coli (n = 43, 26.4%) and Citrobacter koseri (n = 11, 6.7%). Environmental sampling was performed in 24 hospitals and 604 sites. A total of 12 sites (2.0%) were positive for CPE and sink in the nursing station (n = 6, 4.2%) was the most contaminated space. Conclusion CPE colonization rates in patients exposed to CPE in LTCFs were higher than those found in acute care hospitals. Proper infection control measures for detecting and reducing CPE colonization in patients residing in LTCFs are required. Newly admitted patients could also be carriers; therefore, infection control for newly admitted patients also needs to be thorough.

show abstract

Active surveillance at the time of hospital admission for multidrug-resistant microorganisms among patients who had recently been hospitalized at health care facilities

Yoon

Ryu

Lee

et al. 2019

American Journal of Infection Control

View full text Add to dashboard Cite

Active surveillance for carbapenem-resistant Enterobacteriaceae, vancomycin-resistant enterococci and toxigenic Clostridium difficile among patients transferred from long-term care facilities in Korea

Cited by 11 publications

References 7 publications

Prevalence of Multidrug-Resistant Organisms and Risk Factors for Carriage among Patients Transferred from Long-Term Care Facilities

Prevalence of Multidrug-Resistant Organisms and Risk Factors for Carriage among Patients Transferred from Long-Term Care Facilities

Positivity of Carbapenemase-producing Enterobacteriaceae in Patients Following Exposure within Long-term Care Facilities in Seoul, Korea

Active surveillance at the time of hospital admission for multidrug-resistant microorganisms among patients who had recently been hospitalized at health care facilities

Contact Info

Product

Resources

About