Recommendations for the surveillance of multidrug-resistant bacteria in Italian long-term care facilities by the GLISTer working group of the Italian Association of Clinical Microbiologists (AMCLI)

• Published in: Antimicrobial resistance & infection control 2020-07, Vol.9 (1), p.106-12, Article 106
• Main Authors: Aschbacher, Richard, Pagani, Leonardo, Migliavacca, Roberta, Pagani, Laura
• Format: Article
• Language: English
• Subjects: Antibiotics; Antimicrobial agents; Associations; Bacteria; Colonization; Comparative analysis; Disease control; Drug resistance; Drug Resistance, Multiple, Bacterial; E coli; Enterobacteriaceae Infections - epidemiology; Enterobacteriaceae Infections - prevention & control; Epidemiological Monitoring; Epidemiology; Guidelines; Health aspects; Health Planning Guidelines; Humans; Infection; Infection control; Infection Control - methods; Infection Control - organization & administration; Italy; Italy - epidemiology; Laboratories; Long term care; Long term care facilities; Long term health care; Long-Term Care - organization & administration; Long-Term Care - standards; LTCF; MDRO; Medical research; Meropenem; Methicillin; Microbial drug resistance; Microbiology; Multidrug resistant organisms; Nursing care; Nursing Homes - statistics & numerical data; Pathogens; Prevalence; Prospective Studies; Retrospective Studies; Screening; Staphylococcus infections; Surveillance; Working groups
• ISSN: 2047-2994; 2047-2994
• DOI: 10.1186/s13756-020-00771-0

Long-term care facilities (LTCFs) are an important reservoir of multidrug-resistant organisms (MDROs). Colonization of LTCF residents by MDROs is generally higher in Italy compared to other European countries. The present review by the working group for the study of infections in LTCFs (GLISTer) of the Italian Association of Clinical Microbiologists (AMCLI) aims to propose criteria for a laboratory-based surveillance of MDROs in Italian LTCFs.We recommend the adhesion to three levels of laboratory-based MDROs surveillance in LTCFs: i) mandatory MDRO surveillance by cumulative retrospective analysis of antimicrobial susceptibility data, obtained as part of routine care of clinical specimens. ii) strongly recommended surveillance by active rectal swab cultures or molecular screening to determine colonization with carbapenemase-producing Enterobacterales, should a resident be proven infected. iii) voluntary surveillance by prospective MDRO surveys, mainly based on point prevalence colonization studies, allowing to determine the MDROs baseline prevalence in the facility.Laboratory-based surveillance of MDROs in LTCFs is aimed at providing useful epidemiological information to healthcare providers operating in the facility, but it is only effective if the collected data are used for infection prevention and control purposes, targeting the peculiar aspects of LTCFs.