Predominance of methicillin-resistant Staphylococcus aureus in the residents and environments of long-term care facilities in Taiwan.

BACKGROUND/PURPOSE: This study investigated the distribution and persistence of multidrug resistant organisms (MDROs) including methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and multidrug-resistant Acinetobacter baumannii (MDRAB) in six long-term care facilities (LTCFs). METHODS: We investigated the distribution of MDROs in residents of six LTCFs and their environments from January to December 2016 (intervention period). Active surveillance of colonization of MDROs was performed by culturing rectal and nasal swab samples from the residents every three months. Multilocus sequence typing (MLST) was conducted, and genes for panton-valentine leukocidin (PVL) from MRSA isolates were determined. RESULTS: A total of 521 samples were positive for MDROs, and MRSA was the most common organism (65.1%), followed by MDRAB (11.3%), carbapenem-resistant Klebsiella pneumoniae (11.1%), carbapenem-resistant Escherichia coli (4.6%), and carbapenem-resistant P. aeruginosa (2.1%, n = 11). By a linear regression model, positive MRSA isolates from the environment were found to be statistically significant and associated with the number of colonized LTCF residents (p = 0.01), while the timing of the surveillance culture was not (p = 0.227). The main MLST types associated with PVL-production were sequence type (ST) 59, (40.0%, 24/60), ST30 (21.4%, 3/14), ST8 (87.5%, 14/16), and ST45 (3.6%, 1/28). The susceptibility rates of tetracycline (96.7%), trimethoprim-sulfamethoxazole (96.7%), and ciprofloxacin (81.7%) were statistically significant and higher in MRSA ST59, compared to the rates in MRSA ST45 isolates. CONCLUSIONS: MRSA was the most commonly colonized MDRO, both in the LTCF residents and in the environment, followed by MDRAB and carbapenem-resistant K. pneumoniae.

Presence of multidrug-resistant organisms in the residents and environments of long-term care facilities in Taiwan.

OBJECTIVES: This study investigated the prevalence of multidrug-resistant organisms (MDROs) in the residents and environments of long-term care facilities (LTCFs) in Taiwan. METHODS: We prospectively investigated the distribution of MDROs in residents of six LTCFs and their environments from January 2015 to December 2015 (intervention period). Active surveillance of colonization of MDROs was performed by culturing rectal and nasal swab samples every 3 months for the residents: 63, 79, and 73 in the first, second, and third surveillance investigations, respectively. If MDROs, including methicillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Pseudomonas aeruginosa, and MDR Acinetobacter baumannii were identified, then swab specimens from environmental sources were also collected and cultured. During the study period, several infection control measures were also implemented. RESULTS: The overall infection density decreased significantly from 2.69 per 1000 patient-days in the preintervention (January 2014 to December 2014) to 2.39 per 1000 patient-days during the intervention period (p < 0.001). A total of 154 samples from residents and environmental sources were positive for MDROs. Methicillin-resistant S. aureus (n = 83, 53.9%) was the predominant organism, followed by carbapenem-resistant Enterobacteriaceae (n = 35, 22.7%), MDR A. baumannii (n = 30, 19.5%), and carbapenem-resistant P. aeruginosa (n = 6, 3.9%). The rates of detection of MDROs were 27.9% (60/215) in nasal swabs, 15.8% (34/215) in rectal swabs, and 11.1% (60/542) in the environmental sources. CONCLUSIONS: The distribution and persistence of MDROs varied among the different LTCFs and time periods.

[Epidemiological features of chronic and Alzheimer's diseases in the community-based elderly living in cities and counties in Hebei province].

OBJECTIVE: To understand the epidemiological features of Alzheimer's disease (AD) in the community-based elderly living in cities and counties in Hebei province. METHODS: Under the stratified random sampling method, Mini Mental State Examination (MMSE) was used to evaluate senile dementia and Activity of Daily Living Scale (ADL) and to evaluate the daily lives of the elderly. Related dementia standard on the diagnose of AD and its subtypes was used. Statistically, data was analyzed through SPSS 13.0 software. RESULTS: The overall prevalence was 64.84% (2355/3632) on chronic diseases in those elderly who were over 60 years of age while AD appeared to be high and increased with age. The prevalence rate of dementia was 7.24% (263/3632), in which AD accounted for 4.87% (177/3632). Rates for other chronic diseases were as follows:hypertension (32.35%), diabetes (11.37%), chronic obstructive pulmonary disease (9.25%), coronary heart disease (8.84%) and stroke (7.16%). The prevalence of AD increased with age and was related to the low degree of education having. CONCLUSION: Elderly living in the communities of Hebei province showed high prevalent rates of chronic diseases including AD, which had become the major kind of diseases related to old age.