Abstract
BackgroundResidents of long-term care facilities (LTCFs) colonized with multidrug resistant organisms (MDROs) are often placed under contact isolation to ensure appropriate infection control. This isolation may reduce opportunities for rehabilitation and social stimuli and may also increase medical costs. However, the number of previous studies investigating the duration of colonization in LTCFs is limited. This study was conducted to determine the duration of colonization and risk factors for prolonged carriage of MDROs among residents of a LTCF.MethodsThis retrospective study was conducted in a hospital-affiliated nursing home with 59 beds. Fifty-four residents in the nursing home were isolated for MDROs between January 1, 2013 and December 31, 2015. Clinical data were collected from the charts of these 54 residents, including catheter use, colonizing MDRO species and site, underlying diseases, Charlson Comorbidity Index (CCI) scores, and Barthel index scores before and after isolation. Forty-seven residents were included into the statistic analysis. Multivariate Cox regression analyses were performed using duration of colonization as the dependent variable.ResultsThe most frequently isolated MDROs were vancomycin-resistant enterococci (VRE) (44.7%), and the median duration of colonization was 72 (4–407) days. An increased CCI score significantly increased the risk of prolonged colonization (HR: 0.86, 95% CI: 0.76–0.98, p value 0.02).ConclusionAmong residents of the LTCF, the average duration of MDRO colonization was approximately 3 months. CCI scores were positively associated with the duration of the MDRO colonization of the LTCF residents. Further studies should be conducted to determine whether implementing isolation protocols for MDRO-colonized LTCF residents is associated with a decline in ADL.Trial registrationThe study protocol was approved by the National Center of Excellence for Clinical Trial and Research of the National Taiwan University Hospital (201512080RINB). The date of registration was December 24, 2015.
Highlights
Residents of long-term care facilities (LTCFs) colonized with multidrug resistant organisms (MDROs) are often placed under contact isolation to ensure appropriate infection control
This study reported that wound management, medical device use and pressure ulcers were independent risk factors for MDRO colonization [18]
Enrollment We identified the residents of a single LTCF localized in Taipei City, Taiwan from whom a MDRO was isolated from Jan 1, 2013 to Dec 31, 2015
Summary
Residents of long-term care facilities (LTCFs) colonized with multidrug resistant organisms (MDROs) are often placed under contact isolation to ensure appropriate infection control. This isolation may reduce opportunities for rehabilitation and social stimuli and may increase medical costs. The number of residents living in long-term care facilities (LTCFs) has increased due to changes in societal age structures. Residents of LTCFs may be at increased risk of infection as a result of sharing common living areas and participating in group activities. Residents colonized with multidrug resistant organisms (MDROs) are often placed under contact isolation and prohibited from group activities to ensure infection control. LTCFs perform repeated cultures for MDRO pathogens to determine whether isolation may be discontinued
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