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. 2019 Mar 28;14(3):e0214327.
doi: 10.1371/journal.pone.0214327. eCollection 2019.

Prevalence of multidrug-resistant organisms in nursing homes in Belgium in 2015

Katrien Latour  1   2 , Te-Din Huang  3 , Béatrice Jans  1 , Catherine Berhin  3 , Pierre Bogaerts  3 , Audrey Noel  3 , Claire Nonhoff  4 , Magali Dodémont  4 , Olivier Denis  5 , Margareta Ieven  6 , Katherine Loens  6 , Didier Schoevaerdts  7   8 , Boudewijn Catry  1   5 , Youri Glupczynski  3
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Prevalence of multidrug-resistant organisms in nursing homes in Belgium in 2015

Katrien Latour et al. PLoS One. .

Abstract

Objectives: Following two studies conducted in 2005 and 2011, a third prevalence survey of multidrug-resistant microorganisms (MDRO) was organised in Belgian nursing homes (NHs) using a similar methodology. The aim was to measure the prevalence of carriage of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), extended-spectrum β-lactamase producing Enterobacteriaceae (ESBLE) and carbapenemase-producing Enterobacteriaceae (CPE) in NH residents. Risk factors for MDRO carriage were also explored.

Methods: Up to 51 randomly selected residents per NH were screened for MDRO carriage by trained local nurses between June and October 2015. Rectal swabs were cultured for ESBLE, CPE and VRE, while pooled samples of nose, throat and perineum and chronic wound swabs were obtained for culture of MRSA. Antimicrobial susceptibility testing, molecular detection of resistance genes and strain genotyping were performed. Significant risk factors for MDRO colonization MDRO was determined by univariate and multivariable analysis.

Results: Overall, 1447 residents from 29 NHs were enrolled. The mean weighted prevalence of ESBLE and MRSA colonization was 11.3% and 9.0%, respectively. Co-colonization occurred in 1.8% of the residents. VRE and CPE carriage were identified in only one resident each. Impaired mobility and recent treatment with fluoroquinolones or with combinations of sulphonamides and trimethoprim were identified as risk factors for ESBLE carriage, while for MRSA these were previous MRSA carriage/infection, a stay in several different hospital wards during the past year, and a recent treatment with nitrofuran derivatives. Current antacid use was a predictor for both ESBL and MRSA carriage.

Conclusions: In line with the evolution of MRSA and ESBL colonization/infection in hospitals, a decline in MRSA carriage and an increase in ESBLE prevalence was seen in Belgian NHs between 2005 and 2015. These results show that a systemic approach, including surveillance and enhancement of infection control and antimicrobial stewardship programs is needed in both acute and chronic care facilities.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Distribution of ESBL-producing Enterobacteriaceae by type of enzyme (n = 172 isolates).
See this image and copyright information in PMC

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