Predictors of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci co-colonization among nursing facility patients

Heinze, Kevin; Kabeto, Mohammed U.; Martin, Emily T.; Cassone, Marco; Hicks, Liam; Mody, Lona

doi:10.1016/j.ajic.2018.09.026

Cited by 15 publications

(21 citation statements)

References 35 publications

(50 reference statements)

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“…In contrast, the lowest prevalence of ESBL Enterobacterales, CR Enterobacterales and MRSA have been reported in Oceania [82,106,113,125], Europe [1,13,[18][19][20][21][22]34,83,103,104,[108][109][110]118] and South America [61]. With respect to MDR P. aeruginosa [64,142], A. baumannii [64,74,141], VRE [14,23,33,38,58,59,[64][65][66]73,74,89,97,127,129] and C. difficile [131,[137][138][139], North America reported the highest prevalence. However, remarkably, Asia has the lowest prevalence of VRE [28,60,126] (Table 1, Figure…”

Section: Mdro Prevalencementioning

confidence: 99%

“…11.2%) [12,14,16,[20][21][22]32,43,80,101,102,104,114,123,124], devices (n = 14, 10.4%) [12,18,23,29,30,33,41,[64][65][66]68,80,93,102], and sputum (n = 3, 2.2%) [43,78,141].…”

Section: Studies Includedmentioning

confidence: 99%

“…Studies included in this review were published from 1987 to 2020). The most frequent MDRO analyzed was MRSA (n = 88, 65.6%) [1, followed by ESBL Enterobacterales (n = 51, 38.0%) [1,14,16,[18][19][20][21][22][23]25,31,33,34,39,57,62,73,75,76,82,83,85,89,97, (E. coli and K. pneumoniae), VRE (n = 36, 26.8%) [1,13,14,18,[20][21][22][23]25,28,31,33,34,[37][38][39][57][58][59][60][64][65][66]73,74,…”

Section: Studies Includedmentioning

confidence: 99%

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Prevalence and Risk Factors for Multidrug-Resistant Organisms Colonization in Long-Term Care Facilities Around the World: A Review

et al. 2021

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Elderly people confined to chronic care facilities face an increased risk of acquiring infections by multidrug-resistant organisms (MDROs). This review presents the current knowledge of the prevalence and risk factors for colonization by MDROs in long-term care facilities (LTCF), thereby providing a useful reference to establish objectives for implementing successful antimicrobial stewardship programs (ASPs). We searched in PubMed and Scopus for studies examining the prevalence of MDROs and/or risk factors for the acquisition of MDROs in LTCF. One hundred and thirty-four studies published from 1987 to 2020 were included. The prevalence of MDROs in LTCF varies between the different continents, where Asia reported the highest prevalence of extended-spectrum ß-lactamase (ESBL) Enterobacterales (71.6%), carbapenem resistant (CR) Enterobacterales (6.9%) and methicillin-resistant Staphylococcus aureus (MRSA) (25.6%) and North America the highest prevalence to MDR Pseudomonas aeruginosa (5.4%), MDR Acinetobacter baumannii (15.0%), vancomycin-resistant Enterococcus spp. (VRE) (4.0%), and Clostridioides difficile (26.1%). Furthermore, MDRO prevalence has experienced changes over time, with increases in MDR P. aeruginosa and extended spectrum ß-lactamase producing Enterobacterales observed starting in 2015 and decreases of CR Enterobacterales, MDR A. baumannii, VRE, MRSA and C. difficile. Several risk factors have been found, such as male sex, chronic wounds, the use of medical devices, and previous antibiotic use. The last of these aspects represents one of the most important modifiable factors for reducing colonization with MDROs through implementing ASPs in LTCF.

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Section: Mdro Prevalencementioning

confidence: 99%

“…11.2%) [12,14,16,[20][21][22]32,43,80,101,102,104,114,123,124], devices (n = 14, 10.4%) [12,18,23,29,30,33,41,[64][65][66]68,80,93,102], and sputum (n = 3, 2.2%) [43,78,141].…”

Section: Studies Includedmentioning

confidence: 99%

Section: Studies Includedmentioning

confidence: 99%

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Prevalence and Risk Factors for Multidrug-Resistant Organisms Colonization in Long-Term Care Facilities Around the World: A Review

et al. 2021

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“…However, due to overuse of a wide range of antibiotics, development of drug-resistant bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), has emerged as a serious problem; more than two million people are infected and approximately 700,000 patients die as a result every year [ 10 , 11 , 12 ]. Although a few antibiotics, such as vancomycin, are currently used for the treatment of MRSA infection, emergence of vancomycin-resistant strains, namely vancomycin-resistant enterococci (VRE) and vancomycin-resistant Staphylococcus aureus (VRSA) has been reported, [ 13 ]. Therefore, the development of novel therapeutics, which are functional against drug-resistant bacteria without concerns of inducing resistance, is imperative for the treatment of infected cutaneous wounds [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Nitric Oxide-Releasing S-Nitrosoglutathione-Conjugated Poly(Lactic-Co-Glycolic Acid) Nanoparticles for the Treatment of MRSA-Infected Cutaneous Wounds

et al. 2020

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S-nitrosoglutathione (GSNO) has emerged as a potent agent for the treatment of infected cutaneous wounds. However, fabrication of GSNO-containing nanoparticles has been challenging due to its high hydrophilicity and degradability. The present study aimed to fabricate nanoparticles using newly synthesized GSNO-conjugated poly(lactic-co-glycolic acid) (PLGA) (GSNO-PLGA; GPNPs). Since hydrophilic GSNO was covalently bound to hydrophobic PLGA, loss of GSNO during the nanoparticle fabrication process was minimized, resulting in sufficient loading efficiency (2.32% of GSNO, 0.07 μmol/mg of NO). Real-time NO release analysis revealed biphasic NO release by GPNPs, including initial burst release within 3 min and continuous controlled release for up to 11.27 h, due to the differential degradation rates of the –SNO groups located at the surface and inside of GPNPs. Since GPNPs could deliver NO more efficiently than GSNO in response to increased interaction with bacteria, the former showed enhanced antibacterial effects against methicillin-resistant Staphylococcus aureus (MRSA) at the same equivalent concentrations of NO. Finally, the facilitating effects of GPNPs on infected wound healing were demonstrated in MRSA-challenged full-thickness wound mouse model. Collectively, the results suggested GPNPs as an ideal nanoparticle formulation for the treatment of MRSA-infected cutaneous wounds.

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“…These residents are more likely to have two or more chronic conditions, [5][6][7] be living with serious/advanced illnesses, 8,9 and be nearing the end of their lives. 1,10 Decreased immune function and limited physical mobility among older long-term nursing home residents place them at risk of experiencing negative health outcomes such as healthcare-associated infections, [11][12][13][14] adverse effects from antibiotics use, [15][16][17][18] and increased physical suffering. [19][20][21][22] Furthermore, infections are common at end of life and are associated with high rates of morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Palliative care and infection management at end of life in nursing homes: A descriptive survey

et al. 2020

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Background: Infections are common occurrences at end of life that are associated with high rates of morbidity and mortality among frail elderly individuals. The problem of infections in nursing homes has led to a subsequent overuse and misuse of antibiotics in this already-frail population. Improving palliative care in nursing homes has been proposed as a key strategy to reduce the use of antibiotics. Aim: The aim of this study was to describe the current status of how nursing homes integrates palliative care and infection management at end of life across the nation. Design: This is a cross-sectional survey of nationally representative US nursing homes. Setting/participants: Between November 2017 and October 2018, a survey was conducted with a nationally representative random sample of nursing homes and 892 surveys were completed (49% response rate). The weighted study sample represented 15,381 nursing homes across the nation. Results: Most nursing homes engaged in care plan documentation on what is important to residents (90.43%) and discussed spiritual needs of terminally ill residents (89.50%). In the event of aspiration pneumonia in terminally ill residents, 59.43% of nursing homes responded that resident would be transferred to the hospital. In suspected urinary tract infection among terminally ill residents, 66.62% of nursing homes responded that the resident will be treated with antibiotics. Conclusion: The study found wide variations in nursing home palliative care practices, particularly for timing of end-of-life care discussions, and suboptimal care reported for antibiotic usage. Further education for nursing home staff on appropriate antibiotic usage and best practices to integrate infection management in palliative care at the end of life is needed.

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Predictors of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci co-colonization among nursing facility patients

Cited by 15 publications

References 35 publications

Prevalence and Risk Factors for Multidrug-Resistant Organisms Colonization in Long-Term Care Facilities Around the World: A Review

Prevalence and Risk Factors for Multidrug-Resistant Organisms Colonization in Long-Term Care Facilities Around the World: A Review

Nitric Oxide-Releasing S-Nitrosoglutathione-Conjugated Poly(Lactic-Co-Glycolic Acid) Nanoparticles for the Treatment of MRSA-Infected Cutaneous Wounds

Palliative care and infection management at end of life in nursing homes: A descriptive survey

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