Nosokomiale Infektionen,systemischer Antibiotikaeinsatz und multiresistente Erreger bei Bewohnern von Altenpflegeheimen

Background

Residents of long-term care facilities (LTCF) are at risk of healthcare associated infections (HAI) and are often treated with antibiotics. In Germany a current HAI prevalence of 1.6 % and antibiotic use in 1.15?% have been reported. However, data published on the current prevalence of multidrug-resistant organisms (MRDO) in LTCFs in Germany are scarce. Therefore, the prevalence of HAI, antibiotic use and presence of MDROs were investigated in LTCF residents in Frankfurt am Main, Germany.

Methods

A point prevalence study of HAI and antibiotic use according to the European HALT protocol (health care associated infections in long-term care facilities) was carried out; swabs from the nose, throat and perineum were analyzed for methicillin-resistant Staphylococcus aureus (MRSA), extended spectrum beta-lactamase producing enterobacteria (ESBL) and vancomycin-resistant enterococci (VRE).

Results

A total of 880 residents in 8 LTCFs were enrolled in the study in 2012. The study participants were 30?% male, 46.7?%? were more than 85 years old, 70?% exhibitied urinary or fecal incontinence, 11.4?% had an indwelling urinary catheter and 0.1?% a vascular catheter. Prevalence rates of HAI and of antibiotic use were 2.5 % and 1.5?%, respectively. The prevalence of MDROs in 184 residents who agreed to being tested for MDROs was 9.2?% MRSA, 26.7?% ESBL and 2.7?% VRE.

Conclusion

The HAIs and antibiotic use were comparable to the German HALT data from 2010. Compared to other German studies there is a steadily increasing MRSA problem in German LTCFs. High and increasing ESBL rates have been detected in German LTCFs. Further studies are needed to confirm this trend, preferably encompassing molecular methods to study epidemiology.