Social and clinical predictors of perianal colonisation by multidrug-resistant bacteria for geriatric patients in the internal medicine service.

Autor: Del Carmen Valero-Ubierna M; Service of Preventive Medicine and Public Health, Hospital Universitario San Cecilio, Avenida de la Investigación s/n, 18016, Granada, Spain., Benavente-Fernández A; Service of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain., Pérez de Rojas J; Service of Preventive Medicine and Public Health, Hospital Universitario San Cecilio, Avenida de la Investigación s/n, 18016, Granada, Spain., Moreno-Verdejo F; Service of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain., López-Gómez J; Service of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain., Fernández-Ontiveros S; Service of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain., Chueca-Porcuna N; Service of Microbiology, Hospital Universitario San Cecilio, Granada, Spain.; Instituto Biosanitario de Granada (ibs.GRANADA), Granada, Spain.; CIBERINFEC - Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain., García-Marín C; Service of Preventive Medicine and Public Health, Hospital Universitario San Cecilio, Avenida de la Investigación s/n, 18016, Granada, Spain.; Service of Preventive Medicine and Public Health, Hospital Universitario La Paz, Madrid, Spain., Jiménez-Moleón JJ; Service of Preventive Medicine and Public Health, Hospital Universitario San Cecilio, Avenida de la Investigación s/n, 18016, Granada, Spain.; Instituto Biosanitario de Granada (ibs.GRANADA), Granada, Spain.; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Rivera-Izquierdo M; Service of Preventive Medicine and Public Health, Hospital Universitario San Cecilio, Avenida de la Investigación s/n, 18016, Granada, Spain. mariorivera@ugr.es.; Instituto Biosanitario de Granada (ibs.GRANADA), Granada, Spain. mariorivera@ugr.es.; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. mariorivera@ugr.es.
Jazyk: angličtina
Zdroj: Infection [Infection] 2024 Feb; Vol. 52 (1), pp. 231-241. Date of Electronic Publication: 2023 Dec 18.
DOI: 10.1007/s15010-023-02153-1
Abstrakt: Background: Colonisation by multidrug-resistant (MDR) bacteria is a global health issue. The identification of patients with a higher risk of colonisation is essential. Patients admitted to internal medicine services might represent a vulnerable population with a high risk of colonisation. This study was the first to assess social and clinical variables associated with a higher risk of perianal colonisation by MDR bacteria in a Spanish cohort of patients admitted to internal medicine service.
Methods: Patients admitted to an internal medicine service during 12 months of recruitment (1 March 2022 to 1 March 2023) were included in the study. Perianal swabs were performed at admission to identify the presence of MDR bacteria. Social and clinical variables were collected following a directed acyclic graph. A cluster analysis was performed to identify clinical profiles of higher risk. Bivariate analyses and multivariable logistic regression models were fitted to identify potential predictors of MDR bacteria colonisation.
Results: A total of 245 patients, according to the required sample size, were included. Of them, 46 (18.8%) were colonised by MDR bacteria in perianal swabs. Female sex, age > 80 years, dependency on activities of daily living, cognitive deterioration and living in long-term care facilities constituted the highest risk clinical profile. After adjustments, living in long-term care facilities and malnutrition remained the main risk factors identified.
Conclusion: Patients admitted to internal medicine services presented a high frequency of perianal colonisation by MDR bacteria. Social and clinical variables associated with bio-psycho-social susceptibility were associated with colonisation. Special surveillance is needed in internal medicine services to control the transmission.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
Databáze: MEDLINE
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