Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study
Abstract Background Residential care facilities (RCFs) act as reservoirs for multidrug-resistant organisms (MDRO). There are scarce data on colonisation with MDROs in Africa. We aimed to determine the prevalence of MDROs and C. difficile and risk factors for carriage amongst residents of RCFs in Cap...
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | Antimicrobial Resistance and Infection Control |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13756-019-0643-y |
| _version_ | 1818241315530342400 |
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| author | Jason September Leon Geffen Kathryn Manning Preneshni Naicker Cheryl Faro Marc Mendelson Sean Wasserman |
| author_facet | Jason September Leon Geffen Kathryn Manning Preneshni Naicker Cheryl Faro Marc Mendelson Sean Wasserman |
| author_sort | Jason September |
| collection | DOAJ |
| description | Abstract Background Residential care facilities (RCFs) act as reservoirs for multidrug-resistant organisms (MDRO). There are scarce data on colonisation with MDROs in Africa. We aimed to determine the prevalence of MDROs and C. difficile and risk factors for carriage amongst residents of RCFs in Cape Town, South Africa. Methods We performed a cross-sectional surveillance study at three RCFs. Chromogenic agar was used to screen skin swabs for methicillin-resistant S. aureus (MRSA) and stool samples for extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E). Antigen testing and PCR was used to detect Clostridiodes difficile. Risk factors for colonisation were determined with logistic regression. Results One hundred fifty-four residents were enrolled, providing 119 stool samples and 152 sets of skin swabs. Twenty-seven (22.7%) stool samples were positive for ESBL-E, and 13 (8.6%) residents had at least one skin swab positive for MRSA. Two (1.6%) stool samples tested positive for C. difficile. Poor functional status (OR 1.3 (95% CI, 1.0–1.6)) and incontinence (OR 2.9 (95% CI, 1.2–6.9)) were significant predictors for ESBL-E colonisation. MRSA colonization appeared higher in frail care areas (8/58 v 5/94, p = 0.07). Conclusions There was a relatively high prevalence of colonisation with MDROs, particularly ESBL-E, but low C. difficile carriage, with implications for antibiotic prescribing and infection control practice. |
| first_indexed | 2024-12-12T13:27:23Z |
| format | Article |
| id | doaj.art-68bd201e548847baae2585b4d684f1ab |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-12T13:27:23Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-68bd201e548847baae2585b4d684f1ab2022-12-22T00:23:08ZengBMCAntimicrobial Resistance and Infection Control2047-29942019-11-01811810.1186/s13756-019-0643-yColonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence studyJason September0Leon Geffen1Kathryn Manning2Preneshni Naicker3Cheryl Faro4Marc Mendelson5Sean Wasserman6Department of Medicine, University of Cape TownSamson Institute for Ageing Research. Institute of Ageing in Africa, University of Cape TownDepartment of Medicine, University of Cape TownDivision of Medical Microbiology, University of Cape TownDepartment of Medicine, University of Cape TownDepartment of Medicine, University of Cape TownDepartment of Medicine, University of Cape TownAbstract Background Residential care facilities (RCFs) act as reservoirs for multidrug-resistant organisms (MDRO). There are scarce data on colonisation with MDROs in Africa. We aimed to determine the prevalence of MDROs and C. difficile and risk factors for carriage amongst residents of RCFs in Cape Town, South Africa. Methods We performed a cross-sectional surveillance study at three RCFs. Chromogenic agar was used to screen skin swabs for methicillin-resistant S. aureus (MRSA) and stool samples for extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E). Antigen testing and PCR was used to detect Clostridiodes difficile. Risk factors for colonisation were determined with logistic regression. Results One hundred fifty-four residents were enrolled, providing 119 stool samples and 152 sets of skin swabs. Twenty-seven (22.7%) stool samples were positive for ESBL-E, and 13 (8.6%) residents had at least one skin swab positive for MRSA. Two (1.6%) stool samples tested positive for C. difficile. Poor functional status (OR 1.3 (95% CI, 1.0–1.6)) and incontinence (OR 2.9 (95% CI, 1.2–6.9)) were significant predictors for ESBL-E colonisation. MRSA colonization appeared higher in frail care areas (8/58 v 5/94, p = 0.07). Conclusions There was a relatively high prevalence of colonisation with MDROs, particularly ESBL-E, but low C. difficile carriage, with implications for antibiotic prescribing and infection control practice.http://link.springer.com/article/10.1186/s13756-019-0643-yResidential care facilityAntibiotic resistanceC. difficileColonizationMRSAESBL |
| spellingShingle | Jason September Leon Geffen Kathryn Manning Preneshni Naicker Cheryl Faro Marc Mendelson Sean Wasserman Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study Antimicrobial Resistance and Infection Control Residential care facility Antibiotic resistance C. difficile Colonization MRSA ESBL |
| title | Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study |
| title_full | Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study |
| title_fullStr | Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study |
| title_full_unstemmed | Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study |
| title_short | Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study |
| title_sort | colonisation with pathogenic drug resistant bacteria and clostridioides difficile among residents of residential care facilities in cape town south africa a cross sectional prevalence study |
| topic | Residential care facility Antibiotic resistance C. difficile Colonization MRSA ESBL |
| url | http://link.springer.com/article/10.1186/s13756-019-0643-y |
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