Prevalence of Multi-Resistant Microorganisms and Antibiotic Stewardship among Hospitalized Patients Living in Residential Care Homes in Spain: A Cross-Sectional Study

doi:10.3390/antibiotics9060324

. 2020 Jun 13;9(6):324.

doi: 10.3390/antibiotics9060324.

Prevalence of Multi-Resistant Microorganisms and Antibiotic Stewardship among Hospitalized Patients Living in Residential Care Homes in Spain: A Cross-Sectional Study

Mario Rivera-Izquierdo^{1

2

3

4}, Alberto Benavente-Fernández⁵, Jairo López-Gómez⁵, Antonio Jesús Láinez-Ramos-Bossini⁴, Marta Rodríguez-Camacho⁶, María Del Carmen Valero-Ubierna¹, Luis Miguel Martín-delosReyes^{2

3

7}, Eladio Jiménez-Mejías^{2

3

7}, Elena Moreno-Roldán^{2

3

7}, Pablo Lardelli-Claret^{2

3

7}, Virginia Martínez-Ruiz^{2

3

7}

Affiliations

¹ Service of Preventive Medicine and Public Health, Hospital Universitario San Cecilio, 18016 Granada, Spain.
² Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain.
³ Instituto de Investigación Biosanitaria de Granada, ibs.GRANADA, 18012 Granada, Spain.
⁴ Programme in Clinical Medicine and Public Health, University of Granada, 18016 Granada, Spain.
⁵ Service of Internal Medicine, Hospital Universitario San Cecilio, 18016 Granada, Spain.
⁶ Service of Neurology, Hospital Universitario San Cecilio, 18016 Granada, Spain.
⁷ Consorcio de Investigación Biomédica en Red (CIBER) de Epidemiología y Salud Pública de España, CIBERESP, 28029 Madrid, Spain.

PMID: 32545738
PMCID: PMC7345506
DOI: 10.3390/antibiotics9060324

Prevalence of Multi-Resistant Microorganisms and Antibiotic Stewardship among Hospitalized Patients Living in Residential Care Homes in Spain: A Cross-Sectional Study

Mario Rivera-Izquierdo et al. Antibiotics (Basel). 2020.

. 2020 Jun 13;9(6):324.

doi: 10.3390/antibiotics9060324.

Authors

Affiliations

¹ Service of Preventive Medicine and Public Health, Hospital Universitario San Cecilio, 18016 Granada, Spain.
² Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain.
³ Instituto de Investigación Biosanitaria de Granada, ibs.GRANADA, 18012 Granada, Spain.
⁴ Programme in Clinical Medicine and Public Health, University of Granada, 18016 Granada, Spain.
⁵ Service of Internal Medicine, Hospital Universitario San Cecilio, 18016 Granada, Spain.
⁶ Service of Neurology, Hospital Universitario San Cecilio, 18016 Granada, Spain.
⁷ Consorcio de Investigación Biomédica en Red (CIBER) de Epidemiología y Salud Pública de España, CIBERESP, 28029 Madrid, Spain.

PMID: 32545738
PMCID: PMC7345506
DOI: 10.3390/antibiotics9060324

Abstract

Antimicrobial resistance is a growing global health problem. Patients living in care homes are a vulnerable high-risk population colonized by multidrug-resistant organisms (MDRO). We identified a case series of 116 residents of care homes from a cohort of 540 consecutive patients admitted to the internal medicine service of our hospital. We performed early diagnostic tests of MDRO through anal exudates in our sample. The prevalence of MDRO colonization was 34.5% of residents and 70% of them had not been previously identified in the clinical records. Previous hospitalizations and in-hospital antibiotic administration were significantly associated with the presence of MDRO. Our results emphasize the need to consider care homes in the planning of regional and national infection control measures and for implementing surveillance systems that monitor the spread of antimicrobial resistance in Spain. Systematic early testing upon admission to hospital services with a high prevalence of patients with MDRO colonization (e.g., internal medicine) could contribute to the adoption of adequate prevention measures. Specific educational programs for care home staff should also be implemented to address this increasing problem.

Keywords: Spain; antibiotic stewardship; care homes; elderly; hospitalization; internal medicine; multidrug resistance; nursing homes.

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Conflict of interest statement

The authors declare no conflict of interest.

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References

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1. Shi L., Chang J., Liu X., Zhai P., Hu S., Li P., Hayat K., Kabba J.A., Feng Z., Yang C., et al. Dispensing antibiotics without a prescription for acute cough associated with common cold at community pharmacies in shenyang, northeastern china: A cross-sectional study. Antibiotics. 2020;9:163. doi: 10.3390/antibiotics9040163. - DOI - PMC - PubMed
1. Kpokiri E.E., Taylor D.G., Smith F.J. Development of antimicrobial stewardship programmes in low and middle-income countries: A mixed-methods study in nigerian hospitals. Antibiotics. 2020;9:204. doi: 10.3390/antibiotics9040204. - DOI - PMC - PubMed

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No specific grant number/Cátedra de Docencia e Investigación SEMERGEN-Medicina de Familia, University of Granada, Spain.

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[1] Laxminarayan R., Duse A., Wattal C., Zaidi A.K., Wertheim H.F., Sumpradit N., Vlieghe E., LevyHara G., Gould I.M., Goossens H., et al. Antibiotic resistance—The need for global solutions. Lancet Infect. Dis. 2013;13:1057–1098. doi: 10.1016/S1473-3099(13)70318-9. - DOI - PubMed

[2] Laxminarayan R., Duse A., Wattal C., Zaidi A.K., Wertheim H.F., Sumpradit N., Vlieghe E., LevyHara G., Gould I.M., Goossens H., et al. Antibiotic resistance—The need for global solutions. Lancet Infect. Dis. 2013;13:1057–1098. doi: 10.1016/S1473-3099(13)70318-9. - DOI - PubMed

[3] Septimus E.J. Antimicrobial resistance: An antimicrobial/diagnostic stewardship and infection prevention approach. Med. Clin. N. Am. 2018;102:819–829. doi: 10.1016/j.mcna.2018.04.005. - DOI - PubMed

[4] Septimus E.J. Antimicrobial resistance: An antimicrobial/diagnostic stewardship and infection prevention approach. Med. Clin. N. Am. 2018;102:819–829. doi: 10.1016/j.mcna.2018.04.005. - DOI - PubMed

[5] World Health Organization Antimicrobial Stewardship Programmes in Health-Care Facilities in Low-and Middle-Income Countries: A WHO Practical Toolkit. [(accessed on 20 May 2020)];2019 Available online: https://apps.who.int/iris/handle/10665/329404. - PMC - PubMed

[6] World Health Organization Antimicrobial Stewardship Programmes in Health-Care Facilities in Low-and Middle-Income Countries: A WHO Practical Toolkit. [(accessed on 20 May 2020)];2019 Available online: https://apps.who.int/iris/handle/10665/329404. - PMC - PubMed

[7] Shi L., Chang J., Liu X., Zhai P., Hu S., Li P., Hayat K., Kabba J.A., Feng Z., Yang C., et al. Dispensing antibiotics without a prescription for acute cough associated with common cold at community pharmacies in shenyang, northeastern china: A cross-sectional study. Antibiotics. 2020;9:163. doi: 10.3390/antibiotics9040163. - DOI - PMC - PubMed

[8] Shi L., Chang J., Liu X., Zhai P., Hu S., Li P., Hayat K., Kabba J.A., Feng Z., Yang C., et al. Dispensing antibiotics without a prescription for acute cough associated with common cold at community pharmacies in shenyang, northeastern china: A cross-sectional study. Antibiotics. 2020;9:163. doi: 10.3390/antibiotics9040163. - DOI - PMC - PubMed

[9] Kpokiri E.E., Taylor D.G., Smith F.J. Development of antimicrobial stewardship programmes in low and middle-income countries: A mixed-methods study in nigerian hospitals. Antibiotics. 2020;9:204. doi: 10.3390/antibiotics9040204. - DOI - PMC - PubMed

[10] Kpokiri E.E., Taylor D.G., Smith F.J. Development of antimicrobial stewardship programmes in low and middle-income countries: A mixed-methods study in nigerian hospitals. Antibiotics. 2020;9:204. doi: 10.3390/antibiotics9040204. - DOI - PMC - PubMed

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Prevalence of Multi-Resistant Microorganisms and Antibiotic Stewardship among Hospitalized Patients Living in Residential Care Homes in Spain: A Cross-Sectional Study

Affiliations

Prevalence of Multi-Resistant Microorganisms and Antibiotic Stewardship among Hospitalized Patients Living in Residential Care Homes in Spain: A Cross-Sectional Study

Authors

Affiliations

Abstract

Conflict of interest statement

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References

Grants and funding

LinkOut - more resources

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