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. 2015 Aug;36(8):930-5.
doi: 10.1017/ice.2015.97. Epub 2015 Apr 29.

Multidrug-Resistant Gram-Negative Bacteria: Inter- and Intradissemination Among Nursing Homes of Residents With Advanced Dementia

Erika M C D'Agata  1 , Daniel Habtemariam  2 , Susan Mitchell  2
Affiliations

Multidrug-Resistant Gram-Negative Bacteria: Inter- and Intradissemination Among Nursing Homes of Residents With Advanced Dementia

Erika M C D'Agata et al. Infect Control Hosp Epidemiol. 2015 Aug.

Abstract

Objective: To quantify the extent of inter- and intra-nursing home transmission of multidrug-resistant gram-negative bacteria (MDRGN) among residents with advanced dementia and characterize MDRGN colonization among these residents.

Design: Prospective cohort study.

Setting: Twenty-two nursing homes in the greater Boston, Massachusetts, area.

Patients: Residents with advanced dementia.

Methods: Serial rectal surveillance cultures for MDRGN and resident characteristics were obtained every 3 months for 12 months or until death. Molecular typing of MDRGN isolates was performed by pulsed-field gel electrophoresis.

Results: A total of 190 MDRGN isolates from 152 residents with advanced dementia were included in the analyses. Both intra- and inter-nursing home transmission were identified. Genetically related MDRGN strains, recovered from different residents, were detected in 18 (82%) of the 22 nursing homes. The percent of clonally related strains in these nursing homes ranged from 0% to 86% (average, 35%). More than 50% of strains were clonally related in 3 nursing homes. Co-colonization with more than 1 different MDRGN species occurred among 28 residents (18.4%). A total of 168 (88.4%), 20 (10.5%), and 2 (1.0%) of MDRGN isolates were resistant to 3, 4, and 5 different antimicrobials or antimicrobial classes, respectively.

Conclusions: MDRGN are spread both within and between nursing homes among residents with advanced dementia. Infection control interventions should begin to target this high-risk group of nursing home residents.

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Conflict of interest statement

Conflict of Interest: All authors report no conflicts to disclose pertinent to this article.

Figures

Figure 1
Figure 1
Percent of clonally-related strains of multidrug-resistant gram-negative bacteria within and between nursing homes among residents with advanced dementia
See this image and copyright information in PMC

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