Duration of colonization with and risk factors for prolonged carriage of multidrug resistant organisms among residents in long-term care facilities
Abstract Background Residents of long-term care facilities (LTCFs) colonized with multidrug resistant organisms (MDROs) are often placed under contact isolation to ensure appropriate infection control. This isolation may reduce opportunities for rehabilitation and social stimuli and may also increas...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-08-01
|
| Series: | Antimicrobial Resistance and Infection Control |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13756-017-0246-4 |
| _version_ | 1818995155009536000 |
|---|---|
| author | I-Wen Lin Chiao-Yu Huang Sung-Ching Pan Yng-Chyi Chen Chia-Ming Li |
| author_facet | I-Wen Lin Chiao-Yu Huang Sung-Ching Pan Yng-Chyi Chen Chia-Ming Li |
| author_sort | I-Wen Lin |
| collection | DOAJ |
| description | Abstract Background Residents of long-term care facilities (LTCFs) colonized with multidrug resistant organisms (MDROs) are often placed under contact isolation to ensure appropriate infection control. This isolation may reduce opportunities for rehabilitation and social stimuli and may also increase medical costs. However, the number of previous studies investigating the duration of colonization in LTCFs is limited. This study was conducted to determine the duration of colonization and risk factors for prolonged carriage of MDROs among residents of a LTCF. Methods This retrospective study was conducted in a hospital-affiliated nursing home with 59 beds. Fifty-four residents in the nursing home were isolated for MDROs between January 1, 2013 and December 31, 2015. Clinical data were collected from the charts of these 54 residents, including catheter use, colonizing MDRO species and site, underlying diseases, Charlson Comorbidity Index (CCI) scores, and Barthel index scores before and after isolation. Forty-seven residents were included into the statistic analysis. Multivariate Cox regression analyses were performed using duration of colonization as the dependent variable. Results The most frequently isolated MDROs were vancomycin-resistant enterococci (VRE) (44.7%), and the median duration of colonization was 72 (4–407) days. An increased CCI score significantly increased the risk of prolonged colonization (HR: 0.86, 95% CI: 0.76–0.98, p value 0.02). Conclusion Among residents of the LTCF, the average duration of MDRO colonization was approximately 3 months. CCI scores were positively associated with the duration of the MDRO colonization of the LTCF residents. Further studies should be conducted to determine whether implementing isolation protocols for MDRO-colonized LTCF residents is associated with a decline in ADL. Trial registration The study protocol was approved by the National Center of Excellence for Clinical Trial and Research of the National Taiwan University Hospital ( 201512080RINB ). The date of registration was December 24, 2015. |
| first_indexed | 2024-12-20T21:09:20Z |
| format | Article |
| id | doaj.art-8d341f8bba9b44b08bec85e27cc1539e |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-20T21:09:20Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-8d341f8bba9b44b08bec85e27cc1539e2022-12-21T19:26:33ZengBMCAntimicrobial Resistance and Infection Control2047-29942017-08-01611710.1186/s13756-017-0246-4Duration of colonization with and risk factors for prolonged carriage of multidrug resistant organisms among residents in long-term care facilitiesI-Wen Lin0Chiao-Yu Huang1Sung-Ching Pan2Yng-Chyi Chen3Chia-Ming Li4Department of Family Medicine, National Taiwan University HospitalDepartment of Family Medicine, Renai BranchDepartment of Internal Medicine, National Taiwan University HospitalDepartment of Nursing, National Taiwan University HospitalDepartment of Family Medicine, National Taiwan University HospitalAbstract Background Residents of long-term care facilities (LTCFs) colonized with multidrug resistant organisms (MDROs) are often placed under contact isolation to ensure appropriate infection control. This isolation may reduce opportunities for rehabilitation and social stimuli and may also increase medical costs. However, the number of previous studies investigating the duration of colonization in LTCFs is limited. This study was conducted to determine the duration of colonization and risk factors for prolonged carriage of MDROs among residents of a LTCF. Methods This retrospective study was conducted in a hospital-affiliated nursing home with 59 beds. Fifty-four residents in the nursing home were isolated for MDROs between January 1, 2013 and December 31, 2015. Clinical data were collected from the charts of these 54 residents, including catheter use, colonizing MDRO species and site, underlying diseases, Charlson Comorbidity Index (CCI) scores, and Barthel index scores before and after isolation. Forty-seven residents were included into the statistic analysis. Multivariate Cox regression analyses were performed using duration of colonization as the dependent variable. Results The most frequently isolated MDROs were vancomycin-resistant enterococci (VRE) (44.7%), and the median duration of colonization was 72 (4–407) days. An increased CCI score significantly increased the risk of prolonged colonization (HR: 0.86, 95% CI: 0.76–0.98, p value 0.02). Conclusion Among residents of the LTCF, the average duration of MDRO colonization was approximately 3 months. CCI scores were positively associated with the duration of the MDRO colonization of the LTCF residents. Further studies should be conducted to determine whether implementing isolation protocols for MDRO-colonized LTCF residents is associated with a decline in ADL. Trial registration The study protocol was approved by the National Center of Excellence for Clinical Trial and Research of the National Taiwan University Hospital ( 201512080RINB ). The date of registration was December 24, 2015.http://link.springer.com/article/10.1186/s13756-017-0246-4ColonizationLong-term care facilitiesMultidrug-resistant organisms |
| spellingShingle | I-Wen Lin Chiao-Yu Huang Sung-Ching Pan Yng-Chyi Chen Chia-Ming Li Duration of colonization with and risk factors for prolonged carriage of multidrug resistant organisms among residents in long-term care facilities Antimicrobial Resistance and Infection Control Colonization Long-term care facilities Multidrug-resistant organisms |
| title | Duration of colonization with and risk factors for prolonged carriage of multidrug resistant organisms among residents in long-term care facilities |
| title_full | Duration of colonization with and risk factors for prolonged carriage of multidrug resistant organisms among residents in long-term care facilities |
| title_fullStr | Duration of colonization with and risk factors for prolonged carriage of multidrug resistant organisms among residents in long-term care facilities |
| title_full_unstemmed | Duration of colonization with and risk factors for prolonged carriage of multidrug resistant organisms among residents in long-term care facilities |
| title_short | Duration of colonization with and risk factors for prolonged carriage of multidrug resistant organisms among residents in long-term care facilities |
| title_sort | duration of colonization with and risk factors for prolonged carriage of multidrug resistant organisms among residents in long term care facilities |
| topic | Colonization Long-term care facilities Multidrug-resistant organisms |
| url | http://link.springer.com/article/10.1186/s13756-017-0246-4 |
| work_keys_str_mv | AT iwenlin durationofcolonizationwithandriskfactorsforprolongedcarriageofmultidrugresistantorganismsamongresidentsinlongtermcarefacilities AT chiaoyuhuang durationofcolonizationwithandriskfactorsforprolongedcarriageofmultidrugresistantorganismsamongresidentsinlongtermcarefacilities AT sungchingpan durationofcolonizationwithandriskfactorsforprolongedcarriageofmultidrugresistantorganismsamongresidentsinlongtermcarefacilities AT yngchyichen durationofcolonizationwithandriskfactorsforprolongedcarriageofmultidrugresistantorganismsamongresidentsinlongtermcarefacilities AT chiamingli durationofcolonizationwithandriskfactorsforprolongedcarriageofmultidrugresistantorganismsamongresidentsinlongtermcarefacilities |