Assessment of race and sex as risk factors for colonization with multidrug-resistant organisms in six nursing homes

2020 ◽  
Vol 41 (10) ◽  
pp. 1222-1224
Author(s):  
Kyle J. Gontjes ◽  
Kristen E. Gibson ◽  
Bonnie J. Lansing ◽  
Lona Mody ◽  
Marco Cassone
Keyword(s):  
Risk Factors ◽  
Sex Differences ◽  
Multidrug Resistant ◽  
Demographic Characteristics ◽  
Body Site ◽  
Home Setting ◽  
Multidrug Resistant Organisms ◽  
Nursing Home Setting ◽  
Male Patients

AbstractThe role of demographic characteristics, such as sex and race, as risk factors for colonization with multidrug-resistant organisms, has not been established in the nursing home setting. We demonstrate significantly higher prevalence overall in male patients, and sex differences are dependent on organism of interest and body site.

scholarly journals 917. Persistence of Multidrug-Resistant Organisms during Occupancy Changes in the Nursing Home Setting, and Impact of Patient Hand Hygiene Assistance

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S493-S493
Author(s):  
Marco Cassone ◽  
Bonnie Lansing ◽  
Julia Mantey ◽  
Kristen Gibson ◽  
Kyle Gontjes ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Multidrug Resistant ◽  
Healthcare Personnel ◽  
Home Setting ◽  
Vancomycin Resistant Enterococci ◽  
Environmental Surfaces ◽  
Multidrug Resistant Organisms ◽  
Patient Assistance ◽  
Nursing Home Setting ◽  
Vancomycin Resistant

Abstract Background We investigated the effect of changes in room occupancy, and patient hand hygiene, on the burden of multidrug-resistant organisms (MDRO) in nursing homes. We assessed: 1/ persistence of MDRO after patients are discharged; and 2/ impact of hand hygiene assistance on colonization and room contamination. Methods Prospective cohort study of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and ceftazidime, ciprofloxacin or meropenem-resistant gram-negative bacilli (rGNB) in 9 single rooms screened three times a week for 34 weeks (five environmental surfaces, plus nares, groin, and hands of enrolled patients). Relative risk (RR) for patient colonization and room contamination were calculated in patient visits based on: 1/ performance of hand hygiene, and 2/ receiving assistance to perform it. Results We collected 4670 swabs over a total of 723 visits. Of 143 patient discharges, 31 times the room was swabbed before another patient was admitted (41 total visits), 48 times the next admitted patient was enrolled and available to be swabbed (295 visits), and 64 times the patient was not enrolled but the environment was sampled (387 total visits) (Figure). Twenty-four (50%) patients were colonized at least once with an MDRO. Rooms were contaminated at least once with MDRO in 72 cases (64%). MDRO persistence during occupancy changes involving at least one screened patient was observed in 21 of 73 cases (29%). In addition, we detected 2 cases of contamination of unoccupied, terminally cleaned rooms with MDRO recovered also in the previous (MRSA) or the following occupancy (VRE). In 40 occasions, patients performed hand hygiene with assistance from healthcare personnel, while in 169 occasions they performed hand hygiene by themselves. Requiring assistance was a risk factor for patient colonization (27.5% vs. 12.4% not requiring assistance (RR 2.20, 95% CI 1.16-4.18), and for room contamination (37.5% vs. 18.9%, RR 1.97, 95% CI 1.18-3.27) (Table). Figure. Example of successive changes in room occupancy. Table. Breakdown of colonization and contamination at each visit according to hand hygiene performance and need for assistance. Conclusion MDRO can persist during changes in patient occupancy. Patients requiring assistance with hand hygiene experienced a higher MDRO burden. These observations call for further investigation of improved cleaning practices and patient assistance. Disclosures All Authors: No reported disclosures

scholarly journals Sex-Specific Differences in Glioblastoma

Cells ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1783
Author(s):  
Anna Carrano ◽  
Juan Jose Juarez ◽  
Diego Incontri ◽  
Antonio Ibarra ◽  
Hugo Guerrero Cazares
Keyword(s):  
Sex Differences ◽  
Immune System ◽  
Molecular Level ◽  
Deep Understanding ◽  
Protective Role ◽  
Men And Women ◽  
Individualized Approach ◽  
Male Patients ◽  
Outcome Differences

Sex differences have been well identified in many brain tumors. Even though glioblastoma (GBM) is the most common primary malignant brain tumor in adults and has the worst outcome, well-established differences between men and women are limited to incidence and outcome. Little is known about sex differences in GBM at the disease phenotype and genetical/molecular level. This review focuses on a deep understanding of the pathophysiology of GBM, including hormones, metabolic pathways, the immune system, and molecular changes, along with differences between men and women and how these dimorphisms affect disease outcome. The information analyzed in this review shows a greater incidence and worse outcome in male patients with GBM compared with female patients. We highlight the protective role of estrogen and the upregulation of androgen receptors and testosterone having detrimental effects on GBM. Moreover, hormones and the immune system work in synergy to directly affect the GBM microenvironment. Genetic and molecular differences have also recently been identified. Specific genes and molecular pathways, either upregulated or downregulated depending on sex, could potentially directly dictate GBM outcome differences. It appears that sexual dimorphism in GBM affects patient outcome and requires an individualized approach to management considering the sex of the patient, especially in relation to differences at the molecular level.

scholarly journals Multi-country cross-sectional study of colonization with multidrug-resistant organisms: protocol and methods for the Antibiotic Resistance in Communities and Hospitals (ARCH) studies

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aditya Sharma ◽  
Ulzii-Orishikh Luvsansharav ◽  
Prabasaj Paul ◽  
Joseph D. Lutgring ◽  
Douglas R. Call ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multidrug Resistant ◽  
Population Based ◽  
Community Dwelling ◽  
Mitigation Strategies ◽  
Invasive Infection ◽  
Cross Sectional ◽  
Global Epidemiology ◽  
Multidrug Resistant Organisms ◽  
High Threat

Abstract Background Antimicrobial resistance is a global health emergency. Persons colonized with multidrug-resistant organisms (MDROs) are at risk for developing subsequent multidrug-resistant infections, as colonization represents an important precursor to invasive infection. Despite reports documenting the worldwide dissemination of MDROs, fundamental questions remain regarding the burden of resistance, metrics to measure prevalence, and determinants of spread. We describe a multi-site colonization survey protocol that aims to quantify the population-based prevalence and associated risk factors for colonization with high-threat MDROs among community dwelling participants and patients admitted to hospitals within a defined population-catchment area. Methods Researchers in five countries (Bangladesh, Chile, Guatemala, Kenya, and India) will conduct a cross-sectional, population-based prevalence survey consisting of a risk factor questionnaire and collection of specimens to evaluate colonization with three high-threat MDROs: extended-spectrum cephalosporin-resistant Enterobacteriaceae (ESCrE), carbapenem-resistant Enterobacteriaceae (CRE), and methicillin-resistant Staphylococcus aureus (MRSA). Healthy adults residing in a household within the sampling area will be enrolled in addition to eligible hospitalized adults. Colonizing isolates of these MDROs will be compared by multilocus sequence typing (MLST) to routinely collected invasive clinical isolates, where available, to determine potential pathogenicity. A colonizing MDRO isolate will be categorized as potentially pathogenic if the MLST pattern of the colonizing isolate matches the MLST pattern of an invasive clinical isolate. The outcomes of this study will be estimates of the population-based prevalence of colonization with ESCrE, CRE, and MRSA; determination of the proportion of colonizing ESCrE, CRE, and MRSA with pathogenic characteristics based on MLST; identification of factors independently associated with ESCrE, CRE, and MRSA colonization; and creation an archive of ESCrE, CRE, and MRSA isolates for future study. Discussion This is the first study to use a common protocol to evaluate population-based prevalence and risk factors associated with MDRO colonization among community-dwelling and hospitalized adults in multiple countries with diverse epidemiological conditions, including low- and middle-income settings. The results will be used to better describe the global epidemiology of MDROs and guide the development of mitigation strategies in both community and healthcare settings. These standardized baseline surveys can also inform future studies seeking to further characterize MDRO epidemiology globally.

scholarly journals The fight against multidrug-resistant organisms: The role of ZnO crystalline defects

2019 ◽  
Vol 99 ◽  
pp. 575-581 ◽  
Author(s):  
Eva de Lucas-Gil ◽  
Adolfo Del Campo ◽  
Laura Pascual ◽  
Mercedes Monte-Serrano ◽  
Javier Menéndez ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Crystalline Defects ◽  
Multidrug Resistant Organisms

Diabetic foot ulcer and multidrug-resistant organisms: risk factors and impact

2004 ◽  
Vol 21 (7) ◽  
pp. 710-715 ◽  
Author(s):  
A. Hartemann-Heurtier ◽  
J. Robert ◽  
S. Jacqueminet ◽  
G. Ha Van ◽  
J. L. Golmard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Multidrug Resistant ◽  
Multidrug Resistant Organisms

scholarly journals Risk factors for multidrug‐resistant organisms among deceased organ donors

2019 ◽  
Vol 19 (9) ◽  
pp. 2468-2478 ◽  
Author(s):  
Judith A. Anesi ◽  
Emily A. Blumberg ◽  
Jennifer H. Han ◽  
Dong H. Lee ◽  
Heather Clauss ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multidrug Resistant ◽  
Organ Donors ◽  
Multidrug Resistant Organisms

scholarly journals The role of the healthcare environment in the spread of multidrug-resistant organisms: update on current best practices for containment

2014 ◽  
Vol 2 (3-4) ◽  
pp. 79-90 ◽  
Author(s):  
Roy F. Chemaly ◽  
Sarah Simmons ◽  
Charles Dale ◽  
Shashank S. Ghantoji ◽  
Maria Rodriguez ◽  
...  
Keyword(s):  
Best Practices ◽  
Multidrug Resistant ◽  
Healthcare Environment ◽  
Multidrug Resistant Organisms
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