Prevalence and Risk Factors for Multidrug-Resistant Organisms Colonization in Long-Term Care Facilities Around the World: A Review.
Prevalence and Risk Factors for Multidrug-Resistant Organisms Colonization in Long-Term Care Facilities Around the World: A Review.
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DOI：
10.3390/antibiotics10060680
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发表时间：
2021-06-07
期刊：
影响因子：
--
通讯作者：
Cisneros JM
中科院分区：
文献类型：
--
作者：
Rodríguez-Villodres Á;Martín-Gandul C;Peñalva G;Guisado-Gil AB;Crespo-Rivas JC;Pachón-Ibáñez ME;Lepe JA;Cisneros JM
被限制在慢性护理机构的老年人面临被耐多药微生物感染的风险增加。本文综述了长期护理设施（LTCF）中mdro定植的流行情况和危险因素的现有知识，从而为制定实施成功的抗菌药物管理计划（asp）的目标提供有用的参考。我们在PubMed和Scopus中检索了关于LTCF中MDROs患病率和/或MDROs获得风险因素的研究。从1987年到2020年发表的134项研究被纳入其中。LTCF中MDROs的患病率在不同大陆之间存在差异，其中亚洲报告的广谱内酰胺酶（ESBL）肠杆菌（71.6%）、耐碳青霉烯（CR）肠杆菌（6.9%）和耐甲氧西林金黄色葡萄球菌（MRSA）（25.6%）的患病率最高，而北美最高的是耐多药铜绿假单胞菌（5.4%）、耐多药鲍曼不动杆菌（15.0%）、耐万古霉素肠球菌（4.0%）。艰难梭菌（26.1%）。此外，随着时间的推移，MDRO的患病率也发生了变化，从2015年开始观察到耐多药P. aeruginosa和产ß-内酰胺酶扩展谱肠杆菌的增加，CR肠杆菌、耐多药A.鲍曼尼、VRE、MRSA和艰难梭菌的减少。已经发现了几个风险因素，如男性、慢性伤口、医疗器械的使用和以前使用抗生素。这些方面中的最后一个是通过在LTCF中实现asp来减少MDROs殖民化的最重要的可修改因素之一。
Elderly people confined to chronic care facilities face an increased risk of acquiring infections by multidrug-resistant organisms (MDROs). This review presents the current knowledge of the prevalence and risk factors for colonization by MDROs in long-term care facilities (LTCF), thereby providing a useful reference to establish objectives for implementing successful antimicrobial stewardship programs (ASPs). We searched in PubMed and Scopus for studies examining the prevalence of MDROs and/or risk factors for the acquisition of MDROs in LTCF. One hundred and thirty-four studies published from 1987 to 2020 were included. The prevalence of MDROs in LTCF varies between the different continents, where Asia reported the highest prevalence of extended-spectrum ß-lactamase (ESBL) Enterobacterales (71.6%), carbapenem resistant (CR) Enterobacterales (6.9%) and methicillin-resistant Staphylococcus aureus (MRSA) (25.6%) and North America the highest prevalence to MDR Pseudomonas aeruginosa (5.4%), MDR Acinetobacter baumannii (15.0%), vancomycin-resistant Enterococcus spp. (VRE) (4.0%), and Clostridioides difficile (26.1%). Furthermore, MDRO prevalence has experienced changes over time, with increases in MDR P. aeruginosa and extended spectrum ß-lactamase producing Enterobacterales observed starting in 2015 and decreases of CR Enterobacterales, MDR A. baumannii, VRE, MRSA and C. difficile. Several risk factors have been found, such as male sex, chronic wounds, the use of medical devices, and previous antibiotic use. The last of these aspects represents one of the most important modifiable factors for reducing colonization with MDROs through implementing ASPs in LTCF.
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影响因子：
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作者：
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DOI：
10.1111/j.1532-5415.2009.02181.x
发表时间：
2009-04-01
影响因子：
6.3
作者：
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通讯作者：
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