Mortality in Thai Nursing Homes Based on Antimicrobial-Resistant <i>Enterobacterales</i> Carriage and COVID-19 Lockdown Timing: A Prospective Cohort Study
Antimicrobial-resistant <i>Enterobacterales</i> carriage and the coronavirus disease 2019 (COVID-19) lockdown measures may impact the incidence all-cause mortality rate among nursing home residents. To determine the all-cause mortality rate in the presence/absence of antimicrobial-resist...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/6/762 |
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| author | Thundon Ngamprasertchai Muthita Vanaporn Sant Muangnoicharoen Wirichada Pan-ngum Narisa Ruenroengbun Pittaya Piroonamornpun Thitiya Ponam Chatnapa Duangdee Phanita Chankete Anupop Jitmuang Visanu Thamlikitkul |
| author_facet | Thundon Ngamprasertchai Muthita Vanaporn Sant Muangnoicharoen Wirichada Pan-ngum Narisa Ruenroengbun Pittaya Piroonamornpun Thitiya Ponam Chatnapa Duangdee Phanita Chankete Anupop Jitmuang Visanu Thamlikitkul |
| author_sort | Thundon Ngamprasertchai |
| collection | DOAJ |
| description | Antimicrobial-resistant <i>Enterobacterales</i> carriage and the coronavirus disease 2019 (COVID-19) lockdown measures may impact the incidence all-cause mortality rate among nursing home residents. To determine the all-cause mortality rate in the presence/absence of antimicrobial-resistant <i>Enterobacterales</i> carriage and the incidence all-cause mortality rate before and during COVID-19 pandemic lockdown, this prospective closed-cohort study was conducted at various types of nursing homes in Bangkok, Thailand, from June 2020 to December 2021. The elderly residents included 142 participants (aged ≥60 years) living in nursing homes ≥3 months, who did not have terminal illnesses. Time-to-event analyses with Cox proportional hazards models and stratified log-rank tests were used. The all-cause mortality rate was 18%, and the incidence all-cause mortality rate was 0.59/1000 person-days in residents who had antimicrobial-resistant <i>Enterobacterales</i> carriage at baseline. Meanwhile, the incidence all-cause mortality rate among noncarriage was 0.17/1000 person-days. The mortality incidence rate of carriage was three times higher than residents who were noncarriage without statistical significance (HR 3.2; 95% CI 0.74, 13.83). Residents in nonprofit nursing homes had a higher mortality rate than those in for-profit nursing homes (OR 9.24; 95% CI 2.14, 39.86). The incidence mortality rate during and before lockdown were 0.62 and 0.30, respectively. Effective infection-control policies akin to hospital-based systems should be endorsed in all types of nursing homes. To limit the interruption of long-term chronic care, COVID-19 prevention should be individualized to nursing homes. |
| first_indexed | 2024-03-10T00:36:08Z |
| format | Article |
| id | doaj.art-2fe9dbfa905f46879d0b56542a39c85a |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T00:36:08Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-2fe9dbfa905f46879d0b56542a39c85a2023-11-23T15:16:50ZengMDPI AGAntibiotics2079-63822022-06-0111676210.3390/antibiotics11060762Mortality in Thai Nursing Homes Based on Antimicrobial-Resistant <i>Enterobacterales</i> Carriage and COVID-19 Lockdown Timing: A Prospective Cohort StudyThundon Ngamprasertchai0Muthita Vanaporn1Sant Muangnoicharoen2Wirichada Pan-ngum3Narisa Ruenroengbun4Pittaya Piroonamornpun5Thitiya Ponam6Chatnapa Duangdee7Phanita Chankete8Anupop Jitmuang9Visanu Thamlikitkul10Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandDepartment of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandDepartment of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandDepartment of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandDepartment of Pharmaceutics (Clinical Pharmacy), Faculty of Pharmacy, Slipakorn University, Nakornprathom 73000, ThailandHospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandHospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandHospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandDepartment of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandDepartment of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, ThailandDepartment of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, ThailandAntimicrobial-resistant <i>Enterobacterales</i> carriage and the coronavirus disease 2019 (COVID-19) lockdown measures may impact the incidence all-cause mortality rate among nursing home residents. To determine the all-cause mortality rate in the presence/absence of antimicrobial-resistant <i>Enterobacterales</i> carriage and the incidence all-cause mortality rate before and during COVID-19 pandemic lockdown, this prospective closed-cohort study was conducted at various types of nursing homes in Bangkok, Thailand, from June 2020 to December 2021. The elderly residents included 142 participants (aged ≥60 years) living in nursing homes ≥3 months, who did not have terminal illnesses. Time-to-event analyses with Cox proportional hazards models and stratified log-rank tests were used. The all-cause mortality rate was 18%, and the incidence all-cause mortality rate was 0.59/1000 person-days in residents who had antimicrobial-resistant <i>Enterobacterales</i> carriage at baseline. Meanwhile, the incidence all-cause mortality rate among noncarriage was 0.17/1000 person-days. The mortality incidence rate of carriage was three times higher than residents who were noncarriage without statistical significance (HR 3.2; 95% CI 0.74, 13.83). Residents in nonprofit nursing homes had a higher mortality rate than those in for-profit nursing homes (OR 9.24; 95% CI 2.14, 39.86). The incidence mortality rate during and before lockdown were 0.62 and 0.30, respectively. Effective infection-control policies akin to hospital-based systems should be endorsed in all types of nursing homes. To limit the interruption of long-term chronic care, COVID-19 prevention should be individualized to nursing homes.https://www.mdpi.com/2079-6382/11/6/762<i>Enterobacterales</i>colonizationnursing homeCOVID-19lockdown |
| spellingShingle | Thundon Ngamprasertchai Muthita Vanaporn Sant Muangnoicharoen Wirichada Pan-ngum Narisa Ruenroengbun Pittaya Piroonamornpun Thitiya Ponam Chatnapa Duangdee Phanita Chankete Anupop Jitmuang Visanu Thamlikitkul Mortality in Thai Nursing Homes Based on Antimicrobial-Resistant <i>Enterobacterales</i> Carriage and COVID-19 Lockdown Timing: A Prospective Cohort Study Antibiotics <i>Enterobacterales</i> colonization nursing home COVID-19 lockdown |
| title | Mortality in Thai Nursing Homes Based on Antimicrobial-Resistant <i>Enterobacterales</i> Carriage and COVID-19 Lockdown Timing: A Prospective Cohort Study |
| title_full | Mortality in Thai Nursing Homes Based on Antimicrobial-Resistant <i>Enterobacterales</i> Carriage and COVID-19 Lockdown Timing: A Prospective Cohort Study |
| title_fullStr | Mortality in Thai Nursing Homes Based on Antimicrobial-Resistant <i>Enterobacterales</i> Carriage and COVID-19 Lockdown Timing: A Prospective Cohort Study |
| title_full_unstemmed | Mortality in Thai Nursing Homes Based on Antimicrobial-Resistant <i>Enterobacterales</i> Carriage and COVID-19 Lockdown Timing: A Prospective Cohort Study |
| title_short | Mortality in Thai Nursing Homes Based on Antimicrobial-Resistant <i>Enterobacterales</i> Carriage and COVID-19 Lockdown Timing: A Prospective Cohort Study |
| title_sort | mortality in thai nursing homes based on antimicrobial resistant i enterobacterales i carriage and covid 19 lockdown timing a prospective cohort study |
| topic | <i>Enterobacterales</i> colonization nursing home COVID-19 lockdown |
| url | https://www.mdpi.com/2079-6382/11/6/762 |
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