期刊
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
卷 50, 期 5, 页码 649-656出版社
ELSEVIER
DOI: 10.1016/j.ijantimicag.2017.08.003
关键词
Extended-spectrum beta-lactamase; Nursing homes; Long-term care facilities; Colonisation
The objectives of this study were to estimate the colonisation rate by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) among residents of long-term care facilities (LTCFs) and to identify pertinent risk factors. A systematic search of PubMed and EMBASE databases for studies published up to May 2016 that provided raw data for gastrointestinal colonisation by ESBL-PE among LTCF residents was performed. Twenty-three studies reporting data on 9775 screened subjects met the inclusion criteria. The pooled prevalence of ESBL-PE among LTCF residents was 18% [95% confidence interval (CI) 12-24%]. Risk factors for colonisation included recent antibiotic use (within 6 months) [odds ratio (OR) = 2.06, 95% CI 1.78-2.38], previous hospitalisation (within 2.5 years) (OR = 1.50, 95% CI 1.04-2.15), history of invasive procedures (within 2 years) (OR = 2.79, 95% CI 1.66-4.70), previous ESBL-PE colonisation or infection (OR = 6.77, 95% CI 1.33-34.62), history of urinary tract infection (OR = 2.66, 95% CI 1.76-4.01) and urinary catheter use (OR = 2.55, 95% CI 1.29-5.04). In conclusion, almost one in five LTCF residents is colonised with ESBL-PE, and colonised residents are more likely to have a history of recent antibiotic use or health-care facility utilisation. Strict adherence to antimicrobial stewardship in LTCFs is needed to address these high resistance rates. (C) 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.
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