Abstract
BackgroundThere is stigma attached to the identification of residents carrying antimicrobial resistant organisms (ARO) in long term care homes, yet there is a need to collect data about their prevalence for public health surveillance and intervention purposes.ObjectiveWe conducted a point prevalence study to assess ARO rates in long term care homes in Ontario using a secure data collection system.MethodsAll long term care homes in the province were asked to provide colonization or infection counts for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and extended-spectrum beta-lactamase (ESBL) as recorded in their electronic medical records, and the number of current residents. Data was collected online during the October-November 2011 period using a Paillier cryptosystem that allows computation on encrypted data.ResultsA provably secure data collection system was implemented. Overall, 82% of the homes in the province responded. MRSA was the most frequent ARO identified at 3 cases per 100 residents, followed by ESBL at 0.83 per 100 residents, and VRE at 0.56 per 100 residents. The microbiological findings and their distribution were consistent with available provincial laboratory data reporting test results for AROs in hospitals.ConclusionsWe describe an ARO point prevalence study which demonstrated the feasibility of collecting data from long term care homes securely across the province and providing strong privacy and confidentiality assurances, while obtaining high response rates.
Highlights
Antimicrobial resistant organisms (AROs), such as methicillinresistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and extended-spectrum beta-lactamase (ESBL)producing micro-organisms, cause considerable morbidity and mortality, and are, by their nature, difficult to treat and can cause hospitalization and reduction in overall health status of long term care home (LTCH) residents [1]
We describe an ARO point prevalence study which demonstrated the feasibility of collecting data from long term care homes securely across the province and providing strong privacy and confidentiality assurances, while obtaining high response rates
These studies have shown high variability in the proportion of residents of long-term care facilities who are colonized or infected with AROs, with estimates reaching as high as 74.8% of residents found to be carrying at least one ARO [4], and the carriage rate of MRSA varying from 11% to over 48% of residents in LTCHs [7,8,9,10,11]
Summary
Antimicrobial resistant organisms (AROs), such as methicillinresistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and extended-spectrum beta-lactamase (ESBL)producing micro-organisms, cause considerable morbidity and mortality, and are, by their nature, difficult to treat and can cause hospitalization and reduction in overall health status of long term care home (LTCH) residents [1]. A number of studies of the prevalence of AROs in long-term care have been conducted in the United States and in Europe using laboratory confirmation of the micro-organism as the outcome measure [2,3,4,5,6,7,8,9,10,11] These studies have shown high variability in the proportion of residents of long-term care facilities who are colonized or infected with AROs, with estimates reaching as high as 74.8% of residents found to be carrying at least one ARO [4], and the carriage rate of MRSA varying from 11% to over 48% of residents in LTCHs [7,8,9,10,11]. There is stigma attached to the identification of residents carrying antimicrobial resistant organisms (ARO) in long term care homes, yet there is a need to collect data about their prevalence for public health surveillance and intervention purposes
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