Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-24T20:40:22.347Z Has data issue: false hasContentIssue false
  • English
  • Français

Four Years of Surveillance Cultures at a Long-Term Acute Care Hospital

Published online by Cambridge University Press:  02 January 2015

L. Silvia Munoz-Price  and
Alexander Sterner
L. Silvia Munoz-Price*
Affiliation:
Division of Infectious Diseases, University of Miami, Miami, Florida Infection Control Department, Jackson Memorial Hospital, Miami, Florida
Alexander Sterner
Affiliation:
Medical Specialists, Munster, Indiana
*
Jackson Memorial Hospital, Park Plaza West L-302, 1611 NW 12th Ave, Miami, FL 33136 (smunozprice@med.miami.edu)
Get access Rights & Permissions [Opens in a new window]

Extract

Objective.

To characterize the degree of colonization with multidrug-resistant organisms (MDROs) among patients admitted to a long-term acute care hospital.

Design.

Ecologie Study.

Setting.

A 70-bed long-term acute care hospital (a hospital within a hospital) in the greater Chicago area.

Methods.

As part of an infection control initiative, specimens were collected from all consecutively admitted patients for culture of MDROs within 72 hours of admission. Cultures from July 28, 2005, through November 1, 2008, were analyzed on the basis of the bodily site from which the isolate was recovered and the organisms identified. If MDROs were yielded by culture of specimens that were obtained from 24 hours to 30 days after collection of the patient's original set of specimens, these MDROs were removed from the analysis. In addition, repeat rectal swab samples were collected for culture at 2 weeks after admission for all consecutive patients admitted from January 1 through March 31, 2007.

Results.

A total of 1,739 patients with a total of 5,198 specimens met entry criteria. Of the corresponding 5,198 surveillance cultures, 1,580 (30%) were positive for MDROs. Of the 1,739 patients, 947 (54%) had a culture-positive specimen recovered from any site. Vancomycin-resistant Enterococcus was the organism most commonly isolated in cultures of rectal swab samples (in 38% of such cultures) and wounds (in 18% of such cultures). The rate of rectal carriage of vancomycin-resistant Enterococcus increased from 29% in 2005 to 44% in 2008.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 31 , Issue 1 , January 2010 , pp. 59 - 63
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Munoz-Price, LS. Long-term acute care hospitals. Clin Infect Dis 2009;49:438–443.CrossRefGoogle ScholarPubMed
2.Seneff, MG, Wagner, D, Thompson, D, Honeycutt, C, Silver, MR. The impact of long-term acute care facilities of the outcome and cost of care for patients undergoing prolonged mechanical ventilation. Crit Care Med 2000;28:342–350.CrossRefGoogle ScholarPubMed
3.Scheinhorn, DJ, Chao, DC, Hassenpflug, MS, Gracey, DR. Post-ICU weaning from mechanical ventilation: the role of long-term facilities. Chest 2001;120:482S–484S.CrossRefGoogle ScholarPubMed
4.Matte D'Amico, JE, Donnelly, HK, Mutlu, GM, Feinglass, J, Jovanovic, BD, Ndukwu, IM. Risk assessment for inpatient survival in the long-term acute care setting after prolonged critical illness. Chest 2003;124:1039–1045.Google Scholar
5.Lusk, R, O'Bryan, L. Evaluation of critically ill patients for transfer to long-term acute care facilities. Lippincotts Case Manag 2002;7:24–26.CrossRefGoogle ScholarPubMed
6.Gould, CV, Rothenberg, R, Steinberg, JP. Antibiotic resistance in long-term acute care hospitals: the perfect storm. Infect Control Hosp Epidemiol 2006;27:920–925.CrossRefGoogle ScholarPubMed
7.MEDPAC. Report to the Congress: Medicare payment policy. Long-term care hospital services. 2008. Available at: http://www.medpac.gov/chapters/Mar08_Ch02g.pdf. Accessed December 9, 2008.Google Scholar
8.Won, S, Munoz-Price, LS, Lolans, K, et al. Multifacility emergence and rapid spread of KPC+ Enterobacteriaceae in Northwest Indiana (NWI) and Illinois (IL). In: Programs and abstracts of the 19th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America; 2009; San Diego, CA. Arlington, VA: Society for Healthcare Epidemiology of America, 2009. Abstract 67.Google Scholar
9.Furano, JP, Hebden, JN, Standiford, HC, et al. Prevalence of methicillin-resistant Staphylococcus aureus and Adnetobacter baumannii in a long-term acute care facility. Am J Infect Control 2008;36:468–471.CrossRefGoogle Scholar
10.Lolans, K, Rice, TW, Munoz-Price, LS, Quinn, JP. Multicity outbreak of carbapenem-resistant Adnetobacter baumannii isolates producing the car-bapenemase OXA-40. Antimicrob Agents Chemother 2006;50:2941–2945.CrossRefGoogle Scholar
11.Munoz-Price, LS, Lolans, K, Calvert, K, Michael, L, Won, S, Stemer, A. Control of a monoclonal KPC-producing Klebsiella pneumoniae outbreak in a long-term acute care hospital (LTACH). In: Programs and abstracts of the 19th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America; 2009; San Diego, CA. Arlington, VA: Society for Healthcare Epidemiology of America, 2009. Abstract 510.Google Scholar
12.Stephens, C, Francis, SJ, Abell, V, DiPersio, JR, Wells, P. Emergence of resistant Adnetobacter baumannii in critically ill patients within at acute care teaching hospital and a long-term acute care hospital. Am J Infect Control 2007;35:212–215.CrossRefGoogle Scholar