title: Current prevalence of multidrug-resistant organisms in long-term care facilities in the Rhine-Main district, Germany, 2013.
abstract: Multidrug-resistant organisms (MDRO) and in particular multidrug-resistant Gram-negative organisms (MRGN) are an increasing problem in hospital care. However, data on the current prevalence of MDRO in long-term care facilities (LTCFs) are rare. To assess carriage rates of MDRO in LTCF residents in the German Rhine-Main region, we performed a point prevalence survey in 2013. Swabs from nose, throat and perineum were analysed for meticillin-resistant Staphylococcus aureus (MRSA), perianal swabs were analysed for extended-spectrum beta-lactamase (ESBL)-producing organisms, MRGN and vancomycin-resistant enterococci (VRE). In 26 LTCFs, 690 residents were enrolled for analysis of MRSA colonisation and 455 for analysis of rectal carriage of ESBL/MRGN and VRE. Prevalences for MRSA, ESBL/MRGN and VRE were 6.5%, 17.8%, and 0.4%, respectively. MRSA carriage was significantly associated with MRSA history, the presence of urinary catheters, percutaneous endoscopic gastrostomy tubes and previous antibiotic therapy, whereas ESBL/MRGN carriage was exclusively associated with urinary catheters. In conclusion, this study revealed no increase in MRSA prevalence in LTCFs since 2007. In contrast, the rate of ESBL/MRGN carriage in German LTCFs was remarkably high. In nearly all positive residents, MDRO carriage had not been known before, indicating a lack of screening efforts and/or a lack of information on hospital discharge.
authors.affiliation: Institute for Medical Microbiology and Infection Control, University Hospital, Goethe-University, Frankfurt am Main, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hogardt
authors.forename: P
authors.initials: P
authors.lastname: Proba
authors.forename: D
authors.initials: D
authors.lastname: Mischler
authors.forename: C
authors.initials: C
authors.lastname: Cuny
authors.forename: V A
authors.initials: VA
authors.lastname: Kempf
authors.forename: U
authors.initials: U
authors.lastname: Heudorf
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005858:Germany / Q000453:epidemiology; D006268:Health Facilities; D006801:Humans; D008134:Long-Term Care; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D009666:Nose / Q000382:microbiology; D009960:Oropharynx / Q000382:microbiology; D015995:Prevalence; D012007:Rectum / Q000382:microbiology; D012307:Risk Factors; D020713:Vancomycin Resistance; D065507:Vancomycin-Resistant Enterococci / Q000187:drug effects / Q000302:isolation & purification*; D001618:beta-Lactamases
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases