![Sample our Bioscience journals, sign in here to start your access, Latest two full volumes FREE to you for 14 days]({"type":"image" , "src" : "/sda/5925/TOC-Subject-Sample-2021-Bioscience.jpg"})
Abstract
Background: The aims of this study were to investigate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in residents living in Swedish nursing homes, and if carriage of resistant bacteria was related to antibiotic treatment, other risk factors, and/or staff's adherence to guidelines for infection control. Methods: Five hundred and sixty residents from 9 nursing homes on a total of 67 wards participated in the study and had microbiological cultures taken. Faecal samples were obtained from 495 residents (88.3%). ESBL-positive residents were followed for 2 y with repeated sampling. Two hundred and ninety-six staff members were interviewed and observed regarding familiarity with and adherence to infection control guidelines. Results: No resident was positive for MRSA or VRE. Fifteen of the residents were found to be ESBL-positive. Residents living on wards where ESBL-positive residents were identified had been treated more frequently with antibiotics (42%), compared to those on wards where no residents with ESBL were found (28%; p = 0.02). ESBL-positive Escherichia coli isolates from residents living in adjacent rooms were found to be closely genetically related when analysed by pulsed-field gel electrophoresis, indicating transmission between residents. Staff adherence to infection control guidelines sometimes revealed shortcomings, but no significant differences regarding compliance to the guidelines could be found. Conclusion: Carriage of resistant bacteria was uncommon and only ESBL-producing Enterobacteriaceae were identified in Swedish nursing homes. Usage of antibiotics was higher on wards where ESBL-positive residents were detected and there was an indication of transmission of ESBL between residents.
Acknowledgements
The authors express their grateful thanks and appreciation to the medically responsible nurse Annette Arnkil, as well as the staff and residents who participated in this study. We wish to thank Marie Andersson for performing the VRE and ESBL cultures and the PCR analyses. Thanks to Prof. David Leaper for excellent language revision. We also thank the 10 nurse students from Sophiahemmet University College for their help with the sampling, interviews, and observations.
Declaration of interest: The present study was supported by a grant from Strama (the Swedish Strategic Programme Against Antibiotic Resistance) and by a grant from Sophiahemmet University College, Stockholm, Sweden. No conflicts of interest to declare.
Notice of correction
Please note on page 1, line 6–7 of the abstract, the Early Online version of this paper published 10 June 2012 read ‘Two hundred and ninety-five staff members were interviewed and observed’, this has been corrected to two hundred and ninety-six.