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- Title
The Importance of Long-term Acute Care Hospitals in the Regional Epidemiology of Klebsiella pneumoniae Carbapenemase–Producing Enterobacteriaceae.
- Authors
Lin, Michael Y.; Lyles-Banks, Rosie D.; Lolans, Karen; Hines, David W.; Spear, Joel B.; Petrak, Russell; Trick, William E.; Weinstein, Robert A.; Hayden, Mary K.
- Abstract
During region-wide point prevalence surveillance, we detected 9-fold higher rates of colonization with Klebsiella pneumoniae carbapenemase–producing Enterobacteriaceae among patients in long-term acute care hospitals, compared with intensive care unit patients in short-stay acute care hospitals.Background. In the United States, Klebsiella pneumoniae carbapenemase (KPC)–producing Enterobacteriaceae are increasingly detected in clinical infections; however, the colonization burden of these organisms among short-stay and long-term acute care hospitals is unknown.Methods. Short-stay acute care hospitals with adult intensive care units (ICUs) in the city of Chicago were recruited for 2 cross-sectional single-day point prevalence surveys (survey 1, July 2010–January 2011; survey 2, January–July 2011). In addition, all long-term acute care hospitals (LTACHs) in the Chicago region (Cook County) were recruited for a single-day point prevalence survey during January–May 2011. Swab specimens were collected from rectal, inguinal, or urine sites and tested for Enterobacteriaceae carrying blaKPC.Results. We surveyed 24 of 25 eligible short-stay acute care hospitals and 7 of 7 eligible LTACHs. Among LTACHs, 30.4% (119 of 391) of patients were colonized with KPC-producing Enterobacteriaceae, compared to 3.3% (30 of 910) of short-stay hospital ICU patients (prevalence ratio, 9.2; 95% confidence interval, 6.3–13.5). All surveyed LTACHs had patients harboring KPC (prevalence range, 10%–54%), versus 15 of 24 short-stay hospitals (prevalence range, 0%–29%). Several patient-level covariates present at the time of survey—LTACH facility type, mechanical ventilation, and length of stay—were independent risk factors for KPC-producing Enterobacteriaceae colonization.Conclusions. We identified high colonization prevalence of KPC-producing Enterobacteriaceae among patients in LTACHs. Patients with chronic medical care needs in long-term care facilities may play an important role in the spread of these extremely drug-resistant pathogens.
- Subjects
KLEBSIELLA pneumoniae; INTENSIVE care nursing; EPIDEMIOLOGY; ENTEROBACTERIACEAE; NOSOCOMIAL infections; MEDICAL statistics
- Publication
Clinical Infectious Diseases, 2013, Vol 57, Issue 9, p1246
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/cit500