Multidrug-resistant Gram-negative Bacteria in a Long-term Care Facility: Prevalence and Risk Factors

Overview

Journal J Am Geriatr Soc

Specialty Geriatrics

Date 2008 Jun 19

PMID 18557965

Citations 49

Authors

Aurora Pop-Vicas

Susan L Mitchell

Ruth Kandel

Robert Schreiber

Erika M C DAgata

Affiliations

Soon will be listed here.

Abstract

Objectives: To quantify the prevalence, risk factors, and mode of transmission associated with colonization by multidrug-resistant gram-negative bacteria (MDRGN) in the long-term care (LTC) setting.

Design: Cross-sectional.

Setting: Four nursing units in a 648-bed LTC facility in Boston, Massachusetts.

Participants: Eighty-four long-term care residents.

Measurements: Nasal and rectal swabs were obtained to determine colonization with MDRGN; if present, molecular typing was performed. The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) was also determined. Demographic and clinical characteristics were obtained from the medical record. Multivariable analysis was used to identify factors independently associated with MDRGN colonization.

Results: A total of 51%, 28%, and 4% subjects were colonized with MDRGN, MRSA, and VRE, respectively. After multivariable adjustment, advanced dementia (adjusted odds ratio (AOR)=2.9, 95% confidence interval (CI)=1.2-7.35, P=.02) and nonambulatory status (AOR=5.7, 95% CI=1.1-28.9, P=.04) were the only independent risk factors for harboring MDRGN. Molecular typing indicated person-to-person transmission.

Conclusion: Colonization with MDRGN is common in the LTC setting. A diagnosis of advanced dementia is a major risk factor for harboring MDRGN.

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