High prevalence of antimicrobial-resistant organisms in residential aged care facilities

January 01, 0001

High prevalence of antimicrobial-resistant organisms in residential aged care facilities

The aim of this study by researchers from Australia was to assess the frequency of, and risk factors for, colonisation with vancomycin-resistant enterococci (VRE), Clostridium difficile and extended-spectrum alpha-lactamase (ESBL)-producing organisms in residential aged care facilities (RACFs). They conducted a point prevalence survey in October - November 2010 in three RACFs associated with their health service. A single faecal sample was collected from each participating resident and screened for the presence of VRE, C. difficile and ESBL-producing organisms. Presence of risk factors for antibiotic-resistant organisms was identified using a questionnaire. Of 164 residents in the three facilities, 119 (73%) were screened. Mean age of screened residents was 79.2 years, and 61% were women; 74% had resided in the RACF for > 12 months, 21% had been given antibiotics within the past month and 12% had been in an acute care centre within the past 3 months.

Overall rates of VRE (2%) and C. difficile (1%) colonisation were low, but ESBL-producing Escherichia coli was detected in 12% residents overall, with half of these residing in one wing of an RACF (27% of wing residents tested). Ten of the 14 ESBL-producing isolates had identical molecular typing patterns and belonged to genotye CTX-M-9. Eight of 13 residents had persistent colonisation on repeat testing 3 months later.

The researchers concluded: "We found a high prevalence of multiresistant ESBL-producing E. coli in RACF residents. A clonal relatedness of isolates suggests possible transmission within the facility. RACFs should have programs emphasising processes that will limit spread of these organisms, namely good hand hygiene compliance, enhanced environmental cleaning and dedicated antimicrobial stewardship programs."

We have heard all this before, but it is still occurring.

For the full abstract, click here.

MJA 195(9):530-533, 7 November 2011 © 2011 to The Medical Journal of Australia
Prevalence of antimicrobial-resistant organisms in residential aged care facilities. Rhonda L Stuart, Despina Kotsanas, Brooke Webb, Susan Vandergraaf, Elizabeth E Gillespie, Geoffrey G Hogg and Tony M Korman. Correspondence to Rhonda Stuart: [email protected]

Category: HSR. Health Services Research. Keywords: prevalence, antimicrobial-resistant, organisms, residential aged care facilities, point prevalence survey, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 25 November 2011

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