TY - JOUR
T1 - Screening of nursing home residents for colonization with carbapenem-resistant Enterobacteriaceae admitted to acute care hospitals
T2 - Incidence and risk factors
AU - Cunha, Cheston B.
AU - Kassakian, Steven Z.
AU - Chan, Ryan
AU - Tenover, Fred C.
AU - Ziakas, Panos
AU - Chapin, Kimberle C.
AU - Mermel, Leonard A.
N1 - Publisher Copyright:
© 2016 Association for Professionals in Infection Control and Epidemiology, Inc.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Background There are increasing reports of multidrug-resistant gram-negative bacilli in nursing homes and acute care hospitals. Methods We performed a point prevalence survey to detect fecal carriage of gram-negative bacteria carrying carbapenem resistance genes or which were otherwise resistant to carbapenem antibiotics among 500 consecutive admissions from local nursing homes to 2 hospitals in Providence, Rhode Island. We performed a case-control study to identify risk factors associated with carriage of carbapenem-resistant Enterobacteriaceae (CRE). Results There were 404 patients with 500 hospital admissions during which they had rectal swab samples cultured. Fecal carriage of any carbapenem-resistant or carbapenemase- producing gram-negative bacteria was found in 23 (4.6%) of the 500 hospital admissions, including 7 CRE (1.4%), 2 (0.4%) of which were Klebsiella pneumoniae carbapenemase (ie, blaKPC) producing (CPE) Citrobacter freundii, 1 of which was carbapenem susceptible by standard testing methods. Use of a gastrostomy tube was associated with CRE carriage (P =.04). We demonstrated fecal carriage of carbapenem-resistant or carbapenemase-producing gram-negative bacteria in 4.6% of nursing home patients admitted to 2 acute care hospitals, but only 0.4% of such admissions were patients with fecal carriage of CPE. Use of gastrostomy tubes was associated with fecal carriage of gram-negative bacteria with detectable carbapenem resistance. Conclusion CRE fecal carriage is uncommon in our hospital admissions from nursing homes.
AB - Background There are increasing reports of multidrug-resistant gram-negative bacilli in nursing homes and acute care hospitals. Methods We performed a point prevalence survey to detect fecal carriage of gram-negative bacteria carrying carbapenem resistance genes or which were otherwise resistant to carbapenem antibiotics among 500 consecutive admissions from local nursing homes to 2 hospitals in Providence, Rhode Island. We performed a case-control study to identify risk factors associated with carriage of carbapenem-resistant Enterobacteriaceae (CRE). Results There were 404 patients with 500 hospital admissions during which they had rectal swab samples cultured. Fecal carriage of any carbapenem-resistant or carbapenemase- producing gram-negative bacteria was found in 23 (4.6%) of the 500 hospital admissions, including 7 CRE (1.4%), 2 (0.4%) of which were Klebsiella pneumoniae carbapenemase (ie, blaKPC) producing (CPE) Citrobacter freundii, 1 of which was carbapenem susceptible by standard testing methods. Use of a gastrostomy tube was associated with CRE carriage (P =.04). We demonstrated fecal carriage of carbapenem-resistant or carbapenemase-producing gram-negative bacteria in 4.6% of nursing home patients admitted to 2 acute care hospitals, but only 0.4% of such admissions were patients with fecal carriage of CPE. Use of gastrostomy tubes was associated with fecal carriage of gram-negative bacteria with detectable carbapenem resistance. Conclusion CRE fecal carriage is uncommon in our hospital admissions from nursing homes.
KW - Carbapenem resistance
KW - Carbapenem-resistant Enterobacteriaceae
KW - Carbapenemase-producing Enterobacteriaceae
KW - Multidrug resistant organisms
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U2 - 10.1016/j.ajic.2015.09.019
DO - 10.1016/j.ajic.2015.09.019
M3 - Article
C2 - 26631643
AN - SCOPUS:84958932932
SN - 0196-6553
VL - 44
SP - 126
EP - 130
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 2
ER -