Fecal carriage of CTX-M β-lactamase-producing Enterobacteriaceae in nursing homes in the Kinki region of Japan

Figures & data

Table 1 Characteristics of the nursing home residents

Variable	Nursing home
	A	B	C
Capacity	150	100	50
No of residents studied	144	48	33
Age, years (median [range])	85.0 (53–100)	86.5 (52–100)	84.0 (60–98)
Female sex, %	71.5	83.3	75.8
Length of stay, days (median ± SD [range])	300 ± 345 (2–1,490)	105 ± 194 (2–1,015)	87 ± 136 (8–630)

Abbreviation: SD, standard deviation.

Table 2 Prevalence of ESBL-producing Enterobacteriaceae in nursing homes

Variable	Nursing home (n [%])			Total (n [%])
	A	B	C
No of residents studied	144	48	33	225
ESBL-producing	37 (25.7)	9 (18.8)	3 (9.1)	49 (21.7)
Enterobacteriaceae
CTX-M-type ESBL	33 (22.9)	9 (18.8)	2 (6.1)	44 (19.6)
Bacterial species
Escherichia coli	31 (93.9)	8 (88.9)	2 (100.0)	41 (93.2)
Other	2 (6.0)	1 (11.1)	0 (0.0)	3 (6.8)
Enterobacteriaceae

Abbreviation: ESBL, extended-spectrum β-lactamase.

Table 3 Univariate and multivariate logistic regression analyses of risk factors associated with CTX-M-type ESBL-producing Enterobacteriaceae carriage in nursing home A

Characteristics	Univariate analysis		Multivariate analysis
	OR (95% CI)	P value	OR (95% CI)	P value
Required care level
Level 5	3.2	0.009	–
	(1.29–7.914)
Level 1–4	1
Ability to turn over in bed
Incapable	3.50	0.002	2.81	0.019
	(1.56–7.86)		(1.18–6.70)
Capable	1		1
Use of diapers
Yes	2.61	0.021	–
	(1.14–5.99)
No	1
Diabetes
Yes	2.78	0.025	3.22	0.031
	(1.11–6.99)		(1.11–9.32)
No	1		1
Past and present urinary tract infection
Yes	4.13	0.002	–
	(1.61–10.56)
No	1
History of hospitalization within the last year
Yes	3.16	0.006	–
	(1.37–7.30)
No	1
Invasive procedures within the last 2 years
Yes	4.73	<0.001	4.54	0.001
	(2.06–10.85)		(1.87–11.01)
No	1		1

Notes: Required care level is assessed by the authorized professional people according to the Long-Term Care system of Japan.¹⁵ Five levels of care are distinguished: care level 1 is defined as requiring partial care, whereas care level 5 is defined as impossible to live without care.

Abbreviations: CI, confidence interval; ESBL, extended-spectrum β-lactamase; OR, odds ratio.

MitchellOSPiggottJShimizutaniSAged-care support in Japan: perspectives and challengesBenefits Q200622171816792387

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