Prevalencia y factores asociados a la colonización de microorganismos multirresistentes en centros de larga estancia de Gran Canaria

Rosario-Quintana, Cristóbal del; Tosco-Núñez, Tomás; Lorenzo, Leticia; Martı́n-Sánchez, Antonio Manuel; Molina‐Cabrillana, Jesús

doi:10.1016/j.regg.2014.11.006

Cited by 17 publications

(13 citation statements)

References 14 publications

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“…Being known HR-GNR positive in the past was the only significantly associated risk factor, also when corrected for possible confounders. Additionally, studies carried out among long term rehabilitation patients also identified ‘being known HR-GNR positive’ as independent risk factor for HR-GNR colonization [ 30 , 31 ]. This finding suggests that colonization with HR-GNRs persists for a longer period and should not be ignored at re-admission at the hospital.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, risk factors and molecular epidemiology of highly resistant gram negative rods in hospitalized patients in the Dutch region Kennemerland

Souverein

Euser

Herpers

et al. 2016

Antimicrob Resist Infect Control

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BackgroundThis paper describes (1) the Highly Resistant Gram Negative Rod (HR-GNR) prevalence rate, (2) their genotypes, acquired resistance genes and (3) associated risk factors of HR-GNR colonization among the hospitalized population in the Dutch region Kennemerland.MethodsBetween 1 October 2013 and 31 March 2014, cross-sectional prevalence measurements were performed in three regional hospitals as part of each hospitals infection control program. Rectal swabs were analyzed at the Regional Public Health Laboratory Kennemerland by direct culturing. Genotypes and acquired resistance genes of positive isolates were determined using Whole Genome Sequencing with the MiSeq instrument (Illumina). Association between several independent variables and HR-GNR positivity was examined using logistic regression models.ResultsOut of 427 patients, 24 HR-GNR positive isolates were recovered from 22 patients, resulting in a regional HR-GNR colonization prevalence (95 % CI) of 5.2 % (3.6–7.9). Of these 22 positive patients, 15 were Extended Spectrum Beta-Lactamase (ESBL) positive (3.5 % (2.1–5.7)), 7 patients were positive for a Fluoroquinolones and Aminoglycosides (Q&A) resistant Enterobacteriaceae (1.6 % (0.8–3.3)) and from one patient (0.2 % (0–1.3)) a Stenotrophomonas maltophilia resistant towards co-trimoxazole was isolated. No carbapenemase producing Enterobacteriaceae (CPE), multi-resistant Acinetobacter species or multi-resistant Pseudomonas aeruginosa were isolated. The ESBL genes found were blaCTX-M-1 (n = 4, 25.0 %), blaCTX-M-15 (n = 3, 18.8 %), blaCTX-M-27 (n = 2, 12.5 %), blaCTX-M-14b (n = 2, 12.5 %), blaCTX-M-9 (n = 2, 12.5 %), blaCTX-M-14 (n = 1, 6.3 %), blaCTX-M-3 (n = 1, 6.3 %), blaSHV-11 (n = 1, 6.3 %) and blaSHV-12 (n = 1, 6.3 %). Being known HR-GNR positive in the past was the only significant associated risk factor for HR-GNR positivity, odds ratio (95 % CI): 7.32 (1.82–29.35), p-value = 0.005.ConclusionsSimilar ESBL prevalence rates and genotypes (3.5 %) were found in comparison to other Dutch studies. When previously HR-GNR positive patients are readmitted, they should be screened for HR-GNR colonization since colonization with GR-GNRs could be prolonged. We recommend for future studies to include all defined HR-GNRs in addition to ESBLs in prevalence studies, in order to obtain a more comprehensive overview of colonization with HR-GNRs.

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Section: Discussionmentioning

confidence: 99%

Prevalence, risk factors and molecular epidemiology of highly resistant gram negative rods in hospitalized patients in the Dutch region Kennemerland

Souverein

Euser

Herpers

et al. 2016

Antimicrob Resist Infect Control

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“…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%

“…The types of studies were as follows: 99 (73.8%) cross-sectional studies [1,[15][16][17]19,26,[28][29][30][31][32]34,35,37,39,40,[42][43][44]46,47,50,52,54,55,57,[59][60][61][62]65,[68][69][70][71][72][73]75,[77][78][79][80][81][82][83][84][85][87][88][89][91][92]…”

Section: Studies Includedmentioning

confidence: 99%

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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“…Among long-term care residents, independent risk factors found to be associated with colonization for multidrug-resistant organisms include prior colonization or infection by multidrug-resistant organisms, hospitalization in the past 3 months, recurrent urinary tract infections, peripheral arterial disease, current wound management, medical devices in situ, pressure ulcers, advanced dementia, and prolonged antibiotic use. 32,33…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Stewardship in Long-Term Care Facilities: A Call to Action

Morrill

Caffrey

Jump

et al. 2016

Journal of the American Medical Directors Association

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Antimicrobial resistance is a global public health crisis and a national security threat to the United States, as stated in an executive order signed by the president in September 2014. This crisis is a result of indiscriminant antimicrobial use, which promotes selection for resistant organisms, increases the risk of adverse drug events, and renders patients vulnerable to drug-resistant infections. Antimicrobial stewardship is a key measure to combat antimicrobial resistance and specifically seeks to do this by improving antimicrobial use. Antimicrobial stewardship compliments infection control practices and it is important to note that these 2 disciplines are distinct and cannot be discussed interchangeably. Antimicrobial stewardship promotes the appropriate diagnosis, drug, dose, and duration of treatment. The appropriate diagnosis falls into the hands of the prescriber and clinical staff. Optimal antimicrobial drug selection, dosing strategy, and duration of treatment, however, often require expertise in antimicrobial therapy, such as an infectious disease–trained physician or pharmacist. Therefore, successful antimicrobial stewardship programs must be comprehensive and interdisciplinary. Most antimicrobial stewardship programs focus on hospitals; yet, in long-term care, up to 75% of antimicrobial use is inappropriate or unnecessary. Thus, one of the most pressing areas in need for antimicrobial stewardship is in long-term care facilities. Unfortunately, there is little evidence that describes effective antimicrobial stewardship interventions in this setting. This review discusses the need for and barriers to antimicrobial stewardship in long-term care facilities. Additionally, this review describes prior interventions that have been implemented and tested to improve antimicrobial use in long-term care facilities.

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Prevalencia y factores asociados a la colonización de microorganismos multirresistentes en centros de larga estancia de Gran Canaria

Cited by 17 publications

References 14 publications

Prevalence, risk factors and molecular epidemiology of highly resistant gram negative rods in hospitalized patients in the Dutch region Kennemerland

Prevalence, risk factors and molecular epidemiology of highly resistant gram negative rods in hospitalized patients in the Dutch region Kennemerland

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

Antimicrobial Stewardship in Long-Term Care Facilities: A Call to Action

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