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. 2007 Dec;55(12):1921-6.
doi: 10.1111/j.1532-5415.2007.01468.x.

Indwelling device use and antibiotic resistance in nursing homes: identifying a high-risk group

Lona Mody  1 , Shweta Maheshwari, Andrzej Galecki, Carol A Kauffman, Suzanne F Bradley
Affiliations

Indwelling device use and antibiotic resistance in nursing homes: identifying a high-risk group

Lona Mody et al. J Am Geriatr Soc. 2007 Dec.

Abstract

Objectives: To quantify the relationship between indwelling devices (urinary catheters, feeding tubes, and peripherally inserted central catheters) and carriage of antimicrobial-resistant pathogens in nursing home residents.

Design: Cross-sectional.

Setting: Community nursing home in Southeast Michigan.

Participants: Residents with indwelling devices (n=100) and randomly selected control residents (n=100) in 14 nursing homes.

Measurements: Data on age, functional status, and Charlson comorbidity score were collected. Samples were obtained from nares, oropharynx, groin, wounds, perianal area, and enteral feeding tube site. Standard microbiological methods were used to identify methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and ceftazidime-resistant (CTZ-R) gram-negative bacteria (GNB).

Results: Use of indwelling devices was associated with colonization with MRSA at any site (odds ratio (OR)=2.0, P=.04), groin (OR=4.8, P=.006), and perianal area (OR=3.6, P=.01) and CTZ-R GNB at any site (OR=5.6, P=.003). Use of enteral feeding tubes was associated with MRSA colonization in the oropharynx (OR=3.3, P=.02).

Conclusion: Use of indwelling devices is associated with greater colonization with antimicrobial-resistant pathogens. This study serves as an initial step in defining a high-risk group that merits intensive infection control efforts.

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Conflict of interest statement

Conflict of Interest: Funded by Veterans Education and Research Association of Michigan Pilot Grant, National Institute on Aging Grant K23 AG028943, and an Association of Subspecialty Physicians/American Geriatrics Society T. Franklin Williams Research Scholarship.

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