Multidrug-Resistant, Gram-Negative Bacteria in Hospitalized Elderly Patients from Non-Hospital Long-Term Care Facilities
10.3904/kjm.2019.94.1.107
- Author:
Minsung KIM
1
;
JinHo SHIN
;
Yeonsang JEONG
;
Jinkyeong CHO
;
Jae Phil CHOI
Author Information
1. Department of Internal Medicine, Seoul Medical Center, Seoul, Korea. dasole@hanmail.net
- Publication Type:Original Article
- Keywords:
Long-term care;
Aged;
Drug resistance, Multiple, Bacterial
- MeSH:
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
- From:Korean Journal of Medicine
2019;94(1):107-113
- CountryRepublic of Korea
- Language:Korean
-
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.