Prevalence and Risk Factors for Multidrug-Resistant Organisms Colonization in Long-Term Care Facilities Around the World: A Review

Elderly people confined to chronic care facilities face an increased risk of acquiring infections by multidrug-resistant organisms (MDROs). This review presents the current knowledge of the prevalence and risk factors for colonization by MDROs in long-term care facilities (LTCF), thereby providing a...

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Published inAntibiotics (Basel) Vol. 10; no. 6; p. 680
Main Authors Rodríguez-Villodres, Ángel, Martín-Gandul, Cecilia, Peñalva, Germán, Guisado-Gil, Ana Belén, Crespo-Rivas, Juan Carlos, Pachón-Ibáñez, María Eugenia, Lepe, José Antonio, Cisneros, José Miguel
Format Journal Article
LanguageEnglish
Published Basel MDPI AG 07.06.2021
MDPI
Subjects
Antibiotic resistance
Antibiotics
Antiinfectives and antibacterials
Antimicrobial agents
antimicrobial stewardship
Bacteria
Colonization
E coli
Enterobacterales
Epidemiology
Gram-positive bacteria
Health risks
long term care facilities
Long term health care
Long-term care
Medical equipment
Methicillin
Multidrug resistance
Multidrug resistant organisms
multidrug-resistant organism
Nursing homes
Older people
prevalence
Pseudomonas aeruginosa
Public health
Resistance factors
Review
Risk analysis
Risk factors
Staphylococcus aureus
Staphylococcus infections
Vancomycin
β Lactamase
South America
Asia
North America
Europe
Oceania
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Abstract Elderly people confined to chronic care facilities face an increased risk of acquiring infections by multidrug-resistant organisms (MDROs). This review presents the current knowledge of the prevalence and risk factors for colonization by MDROs in long-term care facilities (LTCF), thereby providing a useful reference to establish objectives for implementing successful antimicrobial stewardship programs (ASPs). We searched in PubMed and Scopus for studies examining the prevalence of MDROs and/or risk factors for the acquisition of MDROs in LTCF. One hundred and thirty-four studies published from 1987 to 2020 were included. The prevalence of MDROs in LTCF varies between the different continents, where Asia reported the highest prevalence of extended-spectrum ß-lactamase (ESBL) Enterobacterales (71.6%), carbapenem resistant (CR) Enterobacterales (6.9%) and methicillin-resistant Staphylococcus aureus (MRSA) (25.6%) and North America the highest prevalence to MDR Pseudomonas aeruginosa (5.4%), MDR Acinetobacter baumannii (15.0%), vancomycin-resistant Enterococcus spp. (VRE) (4.0%), and Clostridioides difficile (26.1%). Furthermore, MDRO prevalence has experienced changes over time, with increases in MDR P. aeruginosa and extended spectrum ß-lactamase producing Enterobacterales observed starting in 2015 and decreases of CR Enterobacterales, MDR A. baumannii, VRE, MRSA and C. difficile. Several risk factors have been found, such as male sex, chronic wounds, the use of medical devices, and previous antibiotic use. The last of these aspects represents one of the most important modifiable factors for reducing colonization with MDROs through implementing ASPs in LTCF.
AbstractList Elderly people confined to chronic care facilities face an increased risk of acquiring infections by multidrug-resistant organisms (MDROs). This review presents the current knowledge of the prevalence and risk factors for colonization by MDROs in long-term care facilities (LTCF), thereby providing a useful reference to establish objectives for implementing successful antimicrobial stewardship programs (ASPs). We searched in PubMed and Scopus for studies examining the prevalence of MDROs and/or risk factors for the acquisition of MDROs in LTCF. One hundred and thirty-four studies published from 1987 to 2020 were included. The prevalence of MDROs in LTCF varies between the different continents, where Asia reported the highest prevalence of extended-spectrum ß-lactamase (ESBL) Enterobacterales (71.6%), carbapenem resistant (CR) Enterobacterales (6.9%) and methicillin-resistant Staphylococcus aureus (MRSA) (25.6%) and North America the highest prevalence to MDR Pseudomonas aeruginosa (5.4%), MDR Acinetobacter baumannii (15.0%), vancomycin-resistant Enterococcus spp. (VRE) (4.0%), and Clostridioides difficile (26.1%). Furthermore, MDRO prevalence has experienced changes over time, with increases in MDR P. aeruginosa and extended spectrum ß-lactamase producing Enterobacterales observed starting in 2015 and decreases of CR Enterobacterales, MDR A. baumannii, VRE, MRSA and C. difficile. Several risk factors have been found, such as male sex, chronic wounds, the use of medical devices, and previous antibiotic use. The last of these aspects represents one of the most important modifiable factors for reducing colonization with MDROs through implementing ASPs in LTCF.
Elderly people confined to chronic care facilities face an increased risk of acquiring infections by multidrug-resistant organisms (MDROs). This review presents the current knowledge of the prevalence and risk factors for colonization by MDROs in long-term care facilities (LTCF), thereby providing a useful reference to establish objectives for implementing successful antimicrobial stewardship programs (ASPs). We searched in PubMed and Scopus for studies examining the prevalence of MDROs and/or risk factors for the acquisition of MDROs in LTCF. One hundred and thirty-four studies published from 1987 to 2020 were included. The prevalence of MDROs in LTCF varies between the different continents, where Asia reported the highest prevalence of extended-spectrum ß-lactamase (ESBL) Enterobacterales (71.6%), carbapenem resistant (CR) Enterobacterales (6.9%) and methicillin-resistant Staphylococcus aureus (MRSA) (25.6%) and North America the highest prevalence to MDR Pseudomonas aeruginosa (5.4%), MDR Acinetobacter baumannii (15.0%), vancomycin-resistant Enterococcus spp. (VRE) (4.0%), and Clostridioides difficile (26.1%). Furthermore, MDRO prevalence has experienced changes over time, with increases in MDR P. aeruginosa and extended spectrum ß-lactamase producing Enterobacterales observed starting in 2015 and decreases of CR Enterobacterales , MDR A. baumannii , VRE, MRSA and C. difficile. Several risk factors have been found, such as male sex, chronic wounds, the use of medical devices, and previous antibiotic use. The last of these aspects represents one of the most important modifiable factors for reducing colonization with MDROs through implementing ASPs in LTCF.
Author Cisneros, José Miguel
Rodríguez-Villodres, Ángel
Guisado-Gil, Ana Belén
Martín-Gandul, Cecilia
Peñalva, Germán
Crespo-Rivas, Juan Carlos
Lepe, José Antonio
Pachón-Ibáñez, María Eugenia
AuthorAffiliation 1 Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville (IBiS), University of Seville/CSIC/University Hospital Virgen del Rocío, 41013 Seville, Spain; anrovi1797@gmail.com (Á.R.-V.); cecilia3778@hotmail.com (C.M.-G.); german.penalva@gmail.com (G.P.); anaguigil@gmail.com (A.B.G.-G.); jccresporivas@gmail.com (J.C.C.-R.); mpachon-ibis@us.es (M.E.P.-I.); josealepe@gmail.com (J.A.L.)
2 Department of Pharmacy, University Hospital Virgen del Rocío, 41013 Seville, Spain
AuthorAffiliation_xml – name: 2 Department of Pharmacy, University Hospital Virgen del Rocío, 41013 Seville, Spain
– name: 1 Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville (IBiS), University of Seville/CSIC/University Hospital Virgen del Rocío, 41013 Seville, Spain; anrovi1797@gmail.com (Á.R.-V.); cecilia3778@hotmail.com (C.M.-G.); german.penalva@gmail.com (G.P.); anaguigil@gmail.com (A.B.G.-G.); jccresporivas@gmail.com (J.C.C.-R.); mpachon-ibis@us.es (M.E.P.-I.); josealepe@gmail.com (J.A.L.)
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Snippet Elderly people confined to chronic care facilities face an increased risk of acquiring infections by multidrug-resistant organisms (MDROs). This review...
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SubjectTerms Antibiotic resistance
Antibiotics
Antiinfectives and antibacterials
Antimicrobial agents
antimicrobial stewardship
Bacteria
Colonization
E coli
Enterobacterales
Epidemiology
Gram-positive bacteria
Health risks
long term care facilities
Long term health care
Long-term care
Medical equipment
Methicillin
Multidrug resistance
Multidrug resistant organisms
multidrug-resistant organism
Nursing homes
Older people
prevalence
Pseudomonas aeruginosa
Public health
Resistance factors
Review
Risk analysis
Risk factors
Staphylococcus aureus
Staphylococcus infections
Vancomycin
β Lactamase
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Title Prevalence and Risk Factors for Multidrug-Resistant Organisms Colonization in Long-Term Care Facilities Around the World: A Review
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Volume 10
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