Korean J Med.  2019 Feb;94(1):107-113. 10.3904/kjm.2019.94.1.107.

Multidrug-Resistant, Gram-Negative Bacteria in Hospitalized Elderly Patients from Non-Hospital Long-Term Care Facilities

• Kim M
• Shin J
• Jeong Y
• Cho J
• Choi JP

• KMID: 2438032
• DOI: http://doi.org/10.3904/kjm.2019.94.1.107

Abstract

BACKGROUND/AIMS
We investigated the risk of multidrug-resistant, gram-negative bacteria (MDRGNB) in hospitalized elderly patients from non-hospital long-term care facilities (LTCFs) and the antibiotic prescription pattern.
METHODS
All clinical cultures obtained within 48 hours of hospitalization from elderly patients of at least 55 years of age arriving at a 623-bed, public teaching hospital in Seoul, Republic of Korea from LTCFs between April 1, 2011 and April 1, 2012 were collected retrospectively.
RESULTS
During this period, 365 elderly persons from 13 LTCFs were hospitalized. This study enrolled 135 patients who had cultures performed. In this group, 27.4% harbored MDRGNB at hospitalization. The presence of MDRGNB during prior hospitalization was the only risk factor that predicted harboring it (p = 0.043, odds ratio = 5.00, confidence interval = 1.049-23.834). Combinations of antibiotics or carbapenems were used initially in 35.6% of the patients, and this did not affect the mortality rate in this population.
CONCLUSIONS
Hospitalized elderly patients from non-hospital LTCFs need more attention. Judicious antibiotic selection is needed according to the risk factor of harboring MDRGNB for antibiotics stewardship.

Keyword

Long-term care; Aged; Drug resistance, Multiple, Bacterial

MeSH Terms

Aged*
Anti-Bacterial Agents
Carbapenems
Drug Resistance, Multiple, Bacterial
Gram-Negative Bacteria*
Hospitalization
Hospitals, Teaching
Humans
Long-Term Care*
Mortality
Odds Ratio
Prescriptions
Republic of Korea
Retrospective Studies
Risk Factors
Seoul
Anti-Bacterial Agents
Carbapenems