Prevalence of and risk factors for multidrug-resistant Acinetobacter baumannii colonization among high-risk nursing home residents

To characterize the epidemiology of multidrug-resistant (MDR) Acinetobacter baumannii colonization in high-risk nursing home (NH) residents. Nested case-control study within a multicenter prospective intervention trial. Four NHs in Southeast Michigan. PARTICIPANTS Case patients and control subjects...

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Bibliographic Details
Published in:Infection control and hospital epidemiology 2015-10, Vol.36 (10), p.1155-1162
Main Authors: Mody, Lona, Gibson, Kristen E, Horcher, Amanda, Prenovost, Katherine, McNamara, Sara E, Foxman, Betsy, Kaye, Keith S, Bradley, Suzanne
Format: Article
Language:English
Subjects:
Acinetobacter baumannii - isolation & purification
Acinetobacter Infections - diagnosis
Acinetobacter Infections - epidemiology
Acinetobacter Infections - etiology
Aged
Aged, 80 and over
Antibiotic resistance
Antibiotics
Bacteria
Case-Control Studies
Catheters
Colonization
Drug resistance
Drug Resistance, Multiple, Bacterial
Enrollments
Epidemiology
Female
Homes for the Aged
Humans
Laboratories
Length of stay
Logistic Models
Long term health care
Male
Medical equipment
Medical instruments
Middle Aged
Multidrug resistant organisms
Nursing
Nursing Homes
Ostomy
Parameter estimation
Prevalence
Prospective Studies
Regression analysis
Risk Factors
Staphylococcus infections
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Summary:To characterize the epidemiology of multidrug-resistant (MDR) Acinetobacter baumannii colonization in high-risk nursing home (NH) residents. Nested case-control study within a multicenter prospective intervention trial. Four NHs in Southeast Michigan. PARTICIPANTS Case patients and control subjects were NH residents with an indwelling device (urinary catheter and/or feeding tube) selected from the control arm of the Targeted Infection Prevention study. Cases were residents colonized with MDR (resistant to ≥3 classes of antibiotics) A. baumannii; controls were never colonized with MDR A. baumannii. For active surveillance cultures, specimens from the nares, oropharynx, groin, perianal area, wounds, and device insertion site(s) were collected upon study enrollment, day 14, and monthly thereafter. A. baumannii strains and their susceptibilities were identified using standard microbiologic methods. Of 168 NH residents, 25 (15%) were colonized with MDR A. baumannii. Compared with the 143 controls, cases were more functionally disabled (Physical Self-Maintenance Score >24; odds ratio, 5.1 [95% CI, 1.8-14.9]; P
ISSN:0899-823X
1559-6834
DOI:10.1017/ice.2015.143