scholarly journals Long-Term Care Facility (LTCF) Residents Colonized With Multidrug-Resistant (MDR) Klebsiella pneumoniae Lineages Frequently Causing Infections in Portuguese Clinical Institutions

2017 ◽  
Vol 38 (9) ◽  
pp. 1127-1130 ◽  
Author(s):  
Carla Rodrigues ◽  
Ana C. Mendes ◽  
Filip Sima ◽  
Jan Bavlovič ◽  
Elisabete Machado ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Long Term Care ◽  
Care Facility ◽  
Multidrug Resistant ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

scholarly journals Multidrug-ResistantAcinetobacter baumanniiInfection, Colonization, and Transmission Related to a Long-Term Care Facility Providing Subacute Care

2014 ◽  
Vol 35 (4) ◽  
pp. 406-411 ◽  
Author(s):  
Eva Mortensen ◽  
Kavita K. Trivedi ◽  
Jon Rosenberg ◽  
Sara H. Cody ◽  
Janet Long ◽  
...  
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Multidrug Resistant ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Subacute Care ◽  
Hospital Patients ◽  
Resistance Patterns

Objective.To investigateAcinetobacter baumanniiinfection, colonization, and transmission related to a long-term care facility (LTCF) providing subacute care (facility A).Methods.We reviewed facility A and affiliated local hospital records for facility A residents withA. baumanniiisolated during the period January 2009 through February 2010 and comparedA. baumanniiantimicrobial resistance patterns of residents with those of hospital patients. During March 2010, we implemented a colonization survey of facility A residents who received respiratory support or who could provide sputum samples and looked forA. baumanniicolonization risks. Available clinical and survey isolates underwent pulsed-field gel electrophoresis (PFGE); PFGE strains were linked with overlapping stays to identify possible transmission.Results.During the period January 2009 through February 2010, 33 facility A residents hadA. baumanniiisolates; all strains were multidrug resistant (MDR), which was a significantly higher prevalence of MDR strains than that found among isolates from hospital patients (81 [66%] of 122 hospital patient isolates were MDR;P< .001). The sputum survey found that 14 (20%) of 70 residents hadA. baumanniicolonization, which was associated with ventilator use (adjusted odds ratio, 4.24 [95% confidence interval, 1.06–16.93]); 12 (86%) of 14 isolates were MDR. Four facility A resident groups clustered with 3 PFGE strains and overlapping stays. One of these facility A residents also clustered with 3 patients at an affiliated hospital.Conclusions.We documented substantial MDRA. baumanniiinfections and colonization with probable intra- and interfacility spread associated with a single LTCF providing subacute care. Given the limited infection prevention and antimicrobial stewardship resources in such settings, regional collaborations among facilities across the spectrum of health care are needed to address this MDR threat.

Emergence of multidrug-resistant Proteus mirabilis in a long-term care facility in Croatia

2016 ◽  
Vol 128 (11-12) ◽  
pp. 404-413 ◽  
Author(s):  
Branka Bedenić ◽  
Nataša Firis ◽  
Vesna Elveđi-Gašparović ◽  
Marija Krilanović ◽  
Krešimir Matanović ◽  
...  
Keyword(s):  
Proteus Mirabilis ◽  
Long Term Care ◽  
Care Facility ◽  
Multidrug Resistant ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

Multidrug-Resistant Gram-Negative Bacteria in a Long-Term Care Facility: Prevalence and Risk Factors

2008 ◽  
Vol 56 (7) ◽  
pp. 1276-1280 ◽  
Author(s):  
Aurora Pop-Vicas ◽  
Susan L. Mitchell ◽  
Ruth Kandel ◽  
Robert Schreiber ◽  
Erika M. C. D'Agata
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Care Facility ◽  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
Term Care ◽  
Gram Negative ◽  
Term Care Facility ◽  
Long Term Care Facility

scholarly journals Close proximity interactions support transmission of ESBL-K. pneumoniae but not ESBL-E. coli in healthcare settings

2018 ◽  
Author(s):  
Audrey Duval ◽  
Thomas Obadia ◽  
Pierre-Yves Boëlle ◽  
Eric Fleury ◽  
Jean-Louis Herrmann ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Close Proximity

AbstractAntibiotic-resistance of hospital-acquired infections is a major public health issue. The worldwide emergence and diffusion of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, including Escherichia coli (ESBL-EC) and Klebsiella pneumoniae (ESBL-KP), is of particular concern. Preventing their nosocomial spread requires understanding their transmission. Using Close Proximity Interactions (CPIs), measured by wearable sensors, and weekly ESBL-EC– and ESBL-KP–carriage data, we traced their possible transmission paths among 329 patients in a 200-bed long-term care facility over 4 months. Based on phenotypically defined resistance profiles to 12 antibiotics, new bacterial acquisitions were tracked. Extending a previously proposed statistical method, the CPI network’s ability to support observed incident colonization episodes of ESBL-EC and ESBL-KP was tested. Finally, mathematical modeling based on our findings assessed the effect of several infection-control measures. A potential infector was identified in the CPI network for 80% (16/20) of ESBL-KP acquisition episodes. The lengths of CPI paths between ESBL-KP incident cases and their potential infectors were shorter than predicted by chance (P = 0.02), indicating that CPI-network relationships were consistent with dissemination. Potential ESBL-EC infectors were identified for 54% (19/35) of the acquisitions, with longer-than-expected lengths of CPI paths. These contrasting results yielded differing impacts of infection control scenarios, with contact reduction interventions proving less effective for ESBL-EC than for ESBL-KP. These results highlight the widely variable transmission patterns among ESBL-producing Enterobacteriaceae species CPI networks supported ESBL-KP, but not ESBL-EC spread. These outcomes could help design more specific surveillance and control strategies to prevent in-hospital Enterobacteriaceae dissemination.Author summaryTracing extended-spectrum β-lactamase (ESBL) dissemination in hospitals is an important step in the fight against the spread of multi-drug resistant bacteria. Indeed, understanding ESBL spreading dynamics will help identify efficient control interventions. In the i-Bird study, patients and hospital staff from a French long-term care facility in France carried a wearable sensor to capture their interactions at less than 1.5 meters, every 30 seconds over a 4-month period. Every week, patients were also swabbed to detect carriage of ESBL-producing Enterobacteriaceae. Based on the analysis of these longitudinal data, this study shows that ESBL-producing Klebsiella pneumoniae (ESBL-KP) mostly spreads during close-proximity interactions between individuals, while this is not the case for ESBL-producing Escherichia coli (ESBL-EC), suggesting that ESBL-KP but not ESBL-EC may be controlled by contact reduction interventions.

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