title: Health outcomes of older patients colonized by multi-drug resistant bacteria (MDRB): a one-year follow-up study.
abstract: The objective of this study was to examine whether asymptomatic colonization with MDRB would affect outcomes in older patients one year after hospitalization in a geriatric ward. Patient samples were analyzed to identify specific MDRBs, including methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase-producing Enterobaceriaceae (ESBLE), and vancomycin-resistant enterococci (VRE). Among 337 patients screened at hospital admission, 62 (18%) carried one or more MDRB isolates (MRSA: n=23; ESBLE: n=39; VRE: n=2). At 12 months after admission, 320 patients were interviewed by telephone (17 patients lost to follow up) to assess all-cause mortality, nursing home admissions, functional decline, and hospital readmissions. All-cause mortality rates were similar in MDRB carriers (34%; n=61) and non-carriers (30%; n=259) (P=0.512). Nursing home admission, functional decline, and hospital readmission did not differ between the two groups. In this population, predictors of mortality were: male gender (P=0.002), cognitive disorders at admission (P=0.028), low pre-albumin level at admission (P=0.048), a high level of co-morbidities (P=0.002), and a history of an acute condition in the three months prior to initial hospital admission (P=0.024). In conclusion, in this cohort of older patients, asymptomatic MDRB colonization was not significantly associated with adverse health outcomes at a one-year follow-up after hospitalization. The potential limitations of the study were the small sample size, relatively high mortality rate, and lack of MDRB reassessment during the follow-up.
authors.affiliation: Department of Geriatric Medicine, CHU Mont-Godinne-UCL, 5530 Yvoir, Belgium. didier.schoevaerdts@uclouvain.be
authors.forename: Didier
authors.initials: D
authors.lastname: Schoevaerdts
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Agelas
authors.forename: Marie-Gabrielle
authors.initials: MG
authors.lastname: Ingels
authors.forename: Jacques
authors.initials: J
authors.lastname: Jamart
authors.forename: Malorie
authors.initials: M
authors.lastname: Frennet
authors.forename: Te-Din
authors.initials: TD
authors.lastname: Huang
authors.forename: Christian
authors.initials: C
authors.lastname: Swine
authors.forename: Youri
authors.initials: Y
authors.lastname: Glupczynski
mesh_terms: D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D010359:Patient Readmission / Q000706:statistics & numerical data; D012737:Sex Factors; D013203:Staphylococcal Infections / Q000188:drug therapy; D016019:Survival Analysis; D016896:Treatment Outcome; D020713:Vancomycin Resistance