Screening of nursing home residents for colonization with carbapenem-resistant Enterobacteriaceae admitted to acute care hospitals: Incidence and risk factors
American Journal of Infection Control
Background: There are increasing reports of multidrug-resistant gram-negative bacilli in nursing homes and acute care hospitals.
Methods: We performed a point prevalence survey to detect fecal carriage of gram-negative bacteria carrying carbapenem resistance genes or which were otherwise resistant to carbapenem antibiotics among 500 consecutive admissions from local nursing homes to 2 hospitals in Providence, Rhode Island. We performed a case-control study to identify risk factors associated with carriage of carbapenem-resistant Enterobacteriaceae
Results: There were 404 patients with 500 hospital admissions during which they had rectal swab samples cultured. Fecal carriage of any carbapenem-resistant or carbapenemase- producing gram-negative bacteria was found in 23 (4.6%) of the 500 hospital admissions, including 7 CRE (1.4%), 2 (0.4%) of which were Klebsiella pneumoniae carbapenemase (ie,blaKPC producing (CPE)Citrobacter freundii, 1 of which was carbapenem susceptible by standard testing methods. Use of a gastrostomy tube was associated with CRE carriage (P = .04). We demonstrated fecal carriage of carbapenem-resistant or carbapenemase-producing gram-negative bacteria in 4.6% of nursing home patients admitted to 2 acute care hospitals, but only 0.4% of such admissions were patients with fecal carriage of CPE. Use of gastrostomy tubes was associated with fecal carriage of gram-negative bacteria with detectable carbapenem resistance.
Conclusion: CRE fecal carriage is uncommon in our hospital admissions from nursing homes.
© 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Multidrug resistant organisms, Carbapenem resistance, Carbapenem-resistant Enterobacteriaceae, Carbapenemase-producing Enterobacteriaceae
Cunha, Cheston B.; Kassakian, Steven Z.; Chan, Ryan; Tenover, Fred C.; Ziakas, Panos; Chapin, Kimberle C.; and Mermel, Leonard A., "Screening of nursing home residents for colonization with carbapenem-resistant Enterobacteriaceae admitted to acute care hospitals: Incidence and risk factors" (2016). Biology Faculty Publications. 335.