Prolonged carriage of ESBL-producing enterobacterales and potential cross-transmission among residents in geriatric long-term care facilities
Abstract Previous studies indicated residents in geriatric long-term care facilities (LTCFs) had much higher prevalence of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) carriage than the general population. Most ESBL-E carriers are asymptomatic. The study tested the hypothesis...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-11-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-01190-w |
| _version_ | 1818823186390712320 |
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| author | Ryusuke Ae Teppei Sasahara Akio Yoshimura Koki Kosami Shuji Hatakeyama Kazumasa Sasaki Yumiko Kimura Dai Akine Masanori Ogawa Kenji Hamabata Longzhu Cui |
| author_facet | Ryusuke Ae Teppei Sasahara Akio Yoshimura Koki Kosami Shuji Hatakeyama Kazumasa Sasaki Yumiko Kimura Dai Akine Masanori Ogawa Kenji Hamabata Longzhu Cui |
| author_sort | Ryusuke Ae |
| collection | DOAJ |
| description | Abstract Previous studies indicated residents in geriatric long-term care facilities (LTCFs) had much higher prevalence of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) carriage than the general population. Most ESBL-E carriers are asymptomatic. The study tested the hypothesis that residents with ESBL-E carriage may accumulate inside geriatric LTCFs through potential cross-transmission after exposure to residents with prolonged ESBL-E carriage. 260 residents from four Japanese LTCFs underwent ESBL-E testing of fecal specimens and were divided into two cohorts: Cohort 1,75 patients with ≥ 2 months residence at study onset; Cohort 2, 185 patients with < 2 months residence at study onset or new admission during the study period. Three analyses were performed: (1) ESBL-E carriage statuses in Cohort 1 and Cohort 2; (2) changes in ESBL-E carriage statuses 3–12 months after the first testing and ≥ 12 months after the second testing; and (3) lengths of positive ESBL-E carriage statuses. Compared with the residents in Cohort 1, a significantly larger proportion of residents in Cohort 2 were positive for ESBL-E carriage (28.0% in Cohort 1 vs 40.0% in Cohort 2). In the subsequent testing results, 18.3% of residents who were negative in the first testing showed positive conversion to ESBL-E carriage in the second testing, while no patients who were negative in the second testing showed positive conversion in the third testing. The maximum length of ESBL-E carriage was 17 months. The findings indicated that some residents acquired ESBL-E through potential cross-transmission inside the LTCFs after short-term residence. However, no residents showed positive conversion after long-term residence, which indicates that residents with ESBL-E carriage may not accumulate inside LTCFs. Practical infection control and prevention measures could improve the ESBL-E prevalence in geriatric LTCFs. |
| first_indexed | 2024-12-18T23:35:58Z |
| format | Article |
| id | doaj.art-adb3b3e343184c619a10a040edfb2d77 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-18T23:35:58Z |
| publishDate | 2021-11-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj.art-adb3b3e343184c619a10a040edfb2d772022-12-21T20:47:33ZengNature PortfolioScientific Reports2045-23222021-11-011111910.1038/s41598-021-01190-wProlonged carriage of ESBL-producing enterobacterales and potential cross-transmission among residents in geriatric long-term care facilitiesRyusuke Ae0Teppei Sasahara1Akio Yoshimura2Koki Kosami3Shuji Hatakeyama4Kazumasa Sasaki5Yumiko Kimura6Dai Akine7Masanori Ogawa8Kenji Hamabata9Longzhu Cui10Division of Public Health, Center for Community Medicine, Jichi Medical UniversityDivision of Public Health, Center for Community Medicine, Jichi Medical UniversityMedical Corporation Sanikukai Nissin HospitalDivision of Public Health, Center for Community Medicine, Jichi Medical UniversityDivision of Infectious Diseases, Jichi Medical University HospitalClinical Microbiology Laboratory, Jichi Medical University HospitalClinical Microbiology Laboratory, Jichi Medical University HospitalDivision of Clinical Infectious Diseases, School of Medicine, Jichi Medical UniversityHealth Service Center, Jichi Medical UniversityGerontological Nursing, School of Nursing, Jichi Medical UniversityDivision of Bacteriology, School of Medicine, Jichi Medical UniversityAbstract Previous studies indicated residents in geriatric long-term care facilities (LTCFs) had much higher prevalence of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) carriage than the general population. Most ESBL-E carriers are asymptomatic. The study tested the hypothesis that residents with ESBL-E carriage may accumulate inside geriatric LTCFs through potential cross-transmission after exposure to residents with prolonged ESBL-E carriage. 260 residents from four Japanese LTCFs underwent ESBL-E testing of fecal specimens and were divided into two cohorts: Cohort 1,75 patients with ≥ 2 months residence at study onset; Cohort 2, 185 patients with < 2 months residence at study onset or new admission during the study period. Three analyses were performed: (1) ESBL-E carriage statuses in Cohort 1 and Cohort 2; (2) changes in ESBL-E carriage statuses 3–12 months after the first testing and ≥ 12 months after the second testing; and (3) lengths of positive ESBL-E carriage statuses. Compared with the residents in Cohort 1, a significantly larger proportion of residents in Cohort 2 were positive for ESBL-E carriage (28.0% in Cohort 1 vs 40.0% in Cohort 2). In the subsequent testing results, 18.3% of residents who were negative in the first testing showed positive conversion to ESBL-E carriage in the second testing, while no patients who were negative in the second testing showed positive conversion in the third testing. The maximum length of ESBL-E carriage was 17 months. The findings indicated that some residents acquired ESBL-E through potential cross-transmission inside the LTCFs after short-term residence. However, no residents showed positive conversion after long-term residence, which indicates that residents with ESBL-E carriage may not accumulate inside LTCFs. Practical infection control and prevention measures could improve the ESBL-E prevalence in geriatric LTCFs.https://doi.org/10.1038/s41598-021-01190-w |
| spellingShingle | Ryusuke Ae Teppei Sasahara Akio Yoshimura Koki Kosami Shuji Hatakeyama Kazumasa Sasaki Yumiko Kimura Dai Akine Masanori Ogawa Kenji Hamabata Longzhu Cui Prolonged carriage of ESBL-producing enterobacterales and potential cross-transmission among residents in geriatric long-term care facilities Scientific Reports |
| title | Prolonged carriage of ESBL-producing enterobacterales and potential cross-transmission among residents in geriatric long-term care facilities |
| title_full | Prolonged carriage of ESBL-producing enterobacterales and potential cross-transmission among residents in geriatric long-term care facilities |
| title_fullStr | Prolonged carriage of ESBL-producing enterobacterales and potential cross-transmission among residents in geriatric long-term care facilities |
| title_full_unstemmed | Prolonged carriage of ESBL-producing enterobacterales and potential cross-transmission among residents in geriatric long-term care facilities |
| title_short | Prolonged carriage of ESBL-producing enterobacterales and potential cross-transmission among residents in geriatric long-term care facilities |
| title_sort | prolonged carriage of esbl producing enterobacterales and potential cross transmission among residents in geriatric long term care facilities |
| url | https://doi.org/10.1038/s41598-021-01190-w |
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