当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN GERIATRICS SOCIETY期刊下所有文献 > Functional disability and nursing resource use are predictive of antimicrobial resistance in nursing homes.

Functional disability and nursing resource use are predictive of antimicrobial resistance in nursing homes.

Abstract：

OBJECTIVES:To use a simple measure of activities of daily living, wounds, and indwelling devices (urinary catheter, feeding tube) to predict prevalent, new, and intermittent multidrug-resistant organism (MDRO) acquisition in nursing home (NH) residents. DESIGN:Secondary analysis, prospective cohort study. SETTING:Southeast Michigan NHs (n = 15). PARTICIPANTS:NH residents (N = 111, mean age 81) with two or more monthly visits (729 total). MEASUREMENTS:Monthly microbiological surveillance for MDROs from multiple anatomic sites from enrollment until discharge or 1 year. The Arling scale, previously developed as a measure of NH residents' need (time-intensity) for nursing resources, was used to predict prevalent and time to new or intermittent acquisition (months) of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and antibiotic-resistant gram-negative bacteria (R-GNB) colonization using multiple-failure accelerated time-factor survival analysis, controlling for comorbidity, hospitalization, and antibiotic use in the prior month. RESULTS:One-fifth of participants had a wound, and one-third had a device. There were 60 acquisitions of MRSA, 56 of R-GNB, and 15 of VRE. Expected time to acquisition was less than 1 year for MRSA (median 6.7 months) and R-GNB (median 4.5 months) and more than 1 year for VRE (median 40 months). Arling score was associated with earlier new MRSA and VRE acquisition. A resident with only mild functional impairment and no device or wound would be expected to acquire MRSA in 20 months, versus 5 months for someone needing the most-intense nursing contact. CONCLUSION:MDRO acquisition is common in community NHs. Need for nursing care predicts new MDRO acquisition in NHs, suggesting potential mechanisms for MDRO acquisition and strategies for future interventions for high-risk individuals (e.g., enhanced barrier precautions).

journal_name

J Am Geriatr Soc

journal_title

Journal of the American Geriatrics Society

authors

Min L,Galecki A,Mody L

doi

10.1111/jgs.13353

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

659-66

issue

eissn

0002-8614

issn

1532-5415

journal_volume

pub_type

杂志文章

在线工具

Functional disability and nursing resource use are predictive of antimicrobial resistance in nursing homes.