Four years of surveillance cultures at a long-term acute care hospital.
OBJECTIVE
To characterize the degree of colonization with multidrug-resistant organisms (MDROs) among patients admitted to a long-term acute care hospital.


METHODS
Ecologic study.


METHODS
A 70-bed long-term acute care hospital (a hospital within a hospital) in the greater Chicago area.


METHODS
As part of an infection control initiative, specimens were collected from all consecutively admitted patients for culture of MDROs within 72 hours of admission. Cultures from July 28, 2005, through November 1, 2008, were analyzed on the basis of the bodily site from which the isolate was recovered and the organisms identified. If MDROs were yielded by culture of specimens that were obtained from 24 hours to 30 days after collection of the patient's original set of specimens, these MDROs were removed from the analysis. In addition, repeat rectal swab samples were collected for culture at 2 weeks after admission for all consecutive patients admitted from January 1 through March 31, 2007.


RESULTS
A total of 1,739 patients with a total of 5,198 specimens met entry criteria. Of the corresponding 5,198 surveillance cultures, 1,580 (30%) were positive for MDROs. Of the 1,739 patients, 947 (54%) had a culture-positive specimen recovered from any site. Vancomycin-resistant Enterococcus was the organism most commonly isolated in cultures of rectal swab samples (in 38% of such cultures) and wounds (in 18% of such cultures). The rate of rectal carriage of vancomycin-resistant Enterococcus increased from 29% in 2005 to 44% in 2008.
Munoz-Price
L Silvia
LS
Division of Infectious Diseases, University of Miami, and Infection Control Department, Jackson Memorial Hospital, Miami, Florida 33136, USA. smunozprice@med.miami.edu
Stemer
Alexander
A
D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D002641:Chicago / Q000453:epidemiology; D003470:Culture Media; D024901:Drug Resistance, Multiple, Bacterial; D016983:Enterococcus / Q000187:drug effects / Q000302:isolation & purification; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D006782:Hospitals, Special / Q000706:statistics & numerical data*; D006801:Humans; D017053:Infection Control; D008134:Long-Term Care; D011159:Population Surveillance / Q000379:methods*; D020713:Vancomycin Resistance / Q000187:drug effects
D003470:Culture Media