Prevalence of methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii in a long-term acute care facility.
BACKGROUND
Patients in long-term acute care (LTAC) facilities often have many known risk factors for acquisition of antibiotic-resistant bacteria. However, the prevalence of resistance in these facilities has not been well described.


METHODS
We performed a single-day, point-prevalence study of a 180-bed, university-affiliated LTAC facility in Baltimore to assess the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii in the anterior nares, perirectal area, sputum, and wounds.


RESULTS
Among the 147 patients evaluated, we found a high prevalence of colonization by both MRSA (28%) and A baumannii (30%). Of the A baumannii isolates, 90% were susceptible to imipenem and 92% were susceptible to ampicillin-sulbactam. No isolates were resistant to both imipenem and ampicillin-sulbactam.


CONCLUSIONS
The high prevalence of resistance found in this study supports the need for increased surveillance of patients in the LTAC environment. The fact that these patients are often frequently transferred to tertiary care facilities also supports the need for coordination and collaboration among facilities within the same health care system and the broader geographic area.
Furuno
Jon P
JP
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA. jfuruno@epi.umaryland.edu
Hebden
Joan N
JN
Standiford
Harold C
HC
Perencevich
Eli N
EN
Miller
Ram R
RR
Moore
Anita C
AC
Strauss
Sandra M
SM
Harris
Anthony D
AD
D000046:Academic Medical Centers; D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000302:isolation & purification; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015142:Baltimore / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008134:Long-Term Care; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009666:Nose / Q000382:microbiology; D015995:Prevalence; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D014947:Wounds and Injuries / Q000382:microbiology
D000900:Anti-Bacterial Agents
Infect Control Hosp Epidemiol. 2006 Feb;27(2):170-4
16465633
J Am Geriatr Soc. 2007 May;55(5):775-9
17493200
Emerg Infect Dis. 2005 Oct;11(10):1539-44
16318693
Am J Infect Control. 2007 May;35(4):212-5
17482991
Proc Natl Acad Sci U S A. 2004 Mar 9;101(10):3709-14
14985511
J Clin Epidemiol. 2006 Dec;59(12):1266-73
17098569
Infect Control Hosp Epidemiol. 2007 Jul;28(7):877-9
17564994
Emerg Infect Dis. 2007 Jan;13(1):97-103
17370521
Arch Intern Med. 2006 Mar 13;166(5):580-5
16534047
Infect Control Hosp Epidemiol. 2007 Aug;28(8):945-50
17620242
Am J Infect Control. 2006 Apr;34(3):122-7
16630974
Infect Control Hosp Epidemiol. 2006 Sep;27(9):920-5
16941316