Epidemiology of Multidrug-Resistant Microorganisms among Nursing Home Residents in Belgium

Abstract

ObjectivesA national survey was conducted to determine the prevalence and risk factors of methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum β-lactamases-producing Enterobacteriaceae (ESBLE) and vancomycin-resistant enterococci (VRE) among nursing home residents in Belgium.MethodsA random stratified, national prevalence survey was conducted in nursing home residents who were screened for carriage of ESBLE, MRSA and VRE by multisite enriched culture. Characteristics of nursing homes and residents were collected by a questionnaire survey and were analysed by multilevel logistic regression analysis.ResultsOf 2791 screened residents in 60 participating nursing home, the weighted prevalence of ESBLE and MRSA carriage were 6.2% (range: 0 to 20%) and 12.2% (range: 0 to 36%), respectively. No cases of VRE were found. No relationship was found between ESBLE and MRSA prevalence rates within nursing homes and the rate of co-colonization was very low (0.8%). Geographical variations in prevalence of MRSA and ESBLE and in distribution of ESBL types in nursing home residents paralleled that of acute hospitals. Risk factors of ESBLE carriage included previously known ESBLE carriage, male gender, a low level of mobility and previous antibiotic exposure. Risk factors for MRSA colonization were: previously known MRSA carriage, skin lesions, a low functional status and antacid use.ConclusionsA low prevalence of ESBLE carriage was found in nursing home residents in Belgium. The prevalence of MRSA carriage decreased substantially in comparison to a similar survey conducted in 2005. A low functional status appeared as a common factor for ESBLE and MRSA carriage. Previous exposure to antibiotics was a strong predictor of ESBLE colonization while increased clustering of MRSA carriage suggested the importance of cross-transmission within nursing homes for this organism. These results emphasize the need for global coordination of the surveillance of MDRO within and between nursing homes and hospitals.

MRSA Prevalence and Risk Factors among Health Personnel and Residents in Nursing Homes in Hamburg, Germany – A Cross-Sectional Study

“…More recent studies reported MRSA prevalence of between 2.3 and 9.2% [21–26]. In other European countries, lower prevalence of 0% and 0.3% was reported in Sweden [27] and the Netherlands [28] respectively, but there was also a higher MRSA prevalence of 12.2% in Belgium [29], 7.2% in Luxembourg [30] and 10.6% in Spain [31]. The Hamburg results for MRSA colonisation among residents of nursing homes in non-outbreak situations lie roughly in the middle of this range at 5.5%.…”

Risk Factors for Methicillin Resistant Staphylococcus aureus: A Multi-Laboratory Study

“…On the other hand, residency in a long term care facility was identified as a risk factor for MRSA in our study. A decline of MRSA in nursing homes from 19% in 2005 to 13% in 2010, along with a parallel decline in Belgian hospitals has been documented [11], [12]. Adapted antimicrobial stewardship programs will be needed to combat resistance in these facilities.…”

Prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus strains isolated in a multicenter study of nursing home residents in Croatia

“…Infection control measures and the appropriate use of antibiotics should be monitored to reduce the emergence of multiresistant strains. 21,22 Previous research on colonization of the anterior nares with S aureus has shown that it is unusual for individuals to be colonized with multiple strains of S aureus or with both MSSA and MRSA. 4 In our study, 1 patient had different strains isolated from the anterior nares and a wound sample.…”