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Disability, P. mirabilis, diabetes influence nursing home A. baumannii
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Functional disability, colonization of Proteus mirabilis, and diabetes are significant risk factors for multidrug-resistant Acinetobacter baumannii colonization among nursing home residents, according to recent findings.
Keith S. Kaye, MD, MPH, an Infectious Disease News Editorial Board member, and colleagues evaluated 168 nursing home residents enrolled in the Targeted Infection Prevention trial with an indwelling urinary catheter or a feeding tube in place for more than 72 hours. Active surveillance specimens were taken from the nostrils, oropharynx, groin, perianal area, wounds, and site of device insertion of each participant. Collection occurred at enrollment, on day 15 and each month subsequently for up to 1 year, or until death, discharge or device discontinuation.
The researchers assessed predictors associated with MDR A. Baumannii colonization using standard microbiologic methods to identify strains and their susceptibilities.
Keith S. Kaye
Colonization with MDR A. baumannii was detected in 15% of participants. Compared with those without A. baumannii colonization, cases where colonization was detected suffered from more functional disabilities (OR = 5.1; 95% CI, 1.8-14.9), were more likely to be colonized with P. mirabilis (OR = 5.8; 95% CI, 1.9-17.9) and more frequently had diabetes (OR = 3.4; 95% CI, 1.2-9.9). Eighty-eight percent of A. baumannii cases were colonized with multiple antibiotic-resistant organisms, and 64% were co-colonized with at least one other resistant gram-negative organism.
According to the researchers, these findings suggest the need to better understand and characterize MDR A. baumannii in high-risk nursing home residents.
“Further studies are needed to better define the epidemiology of MDR A. baumannii among high-risk [nursing home] residents, because this growing population may have a pivotal role in the global strategy for controlling the spread of A. baumannii and other MDR organisms,” Kaye and colleagues wrote. – by Jen Byrne
Disclosure: The researchers report no relevant financial disclosures.
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