EPIDEMIOLOGY, RISK FACTORS AND DURATION OF EXTENDED SPECTRUM BETA-LACTAMASE-PRODUCING ENTEROBACTERIACEAE CARRIAGE IN LONG-TERM-CARE FACILITIES
C. Vallet, T. Guillard, A. Debreuve-Theresette, L. Brasme, E. Tardieu, O. Bajolet, F. Munsch, E. Bertin, J. Madoux, F. Bureau-Chalot, C. de Champs
J Aging Res Clin Practice 2013;2(4):392-396
Objectives: To check the long-term care facilities reputation as high risk of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) cross-transmission. To evaluate the prevalence, incidence, risk factors and colonization duration of ESBL-E anal carriage in long term care institution for elderly patients. Design: A six-month prospective longitudinal study. Setting: 120 bed long-term care facilities at a teaching hospital. Participants: 115 patients. Intervention: rectal swabs or stools specimen patients sampled at inclusion and then monthly for ESBL-E detection. Measurements: Participants’ characteristics (e. g. gender, age, Charlson index, functional activities), body mass index (BMI), nutritional parameters, feeding and meal management, C-Reactive Protein, serum albumin level, glycated haemoglobin. Results: Incidence density, prevalence and median duration of ESBL-E carriage were respectively 0.38 /1000 (95 % confidence interval 0.10-0.66) patient days, 4.4 % (95 % confidence interval 0.6-8.1) and 74 (interquartile range 26) days. The estimated probability of negativation was 59 % at 62 days. The main risk factors were male sex, stays in acute care unit during the survey and diet nature. Conclusion: Incidence density, prevalence, and rate of cross-transmission were low. Colonization duration could be linked to bacteria clonal characters.