Healthcare-Associated Infections by Multidrug-Resistant Bacteria in Patients Interned at Long-Term Care Facilities

A special issue of Pathogens (ISSN 2076-0817). This special issue belongs to the section "Bacterial Pathogens".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 1971

Special Issue Editor


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Guest Editor
1. FP-BHS—Fernando Pessoa Biomedical and Health Sciences Research Unit, University Fernando Pessoa, 4249-004 Porto, Portugal
2. (Colaborator) UCIBIO-REQUIMTE—Applied Molecular Biosciences Research Unit, Laboratory of Microbiology, Faculty of Pharmacy, University of Porto, 4099-002 Porto, Portugal
Interests: antimicrobial resistance and infectious diseases; enterobacterales; β-Lactamases; epidemiology of antimicrobial resistance (clones, mobile genetic elements, healthcare institutions, community); role of non-hospital ecological niches in the selection and dissemination of clinically relevant antibiotic resistance genes

Special Issue Information

Dear Colleagues,

Long-term care facilities (LTCF) are becoming an increasingly important component of healthcare delivery systems. They are one of the three levels of healthcare (alongside hospital care and primary healthcare), functioning as an interface between hospital and community. Given the very close relationship with hospitals (e.g., through the constant flow of patients between hospitals and LTCF), many of the problems related to healthcare-associated infections (HAI) and colonization by multidrug-resistant (MDR) bacteria already known in hospitals begin to emerge and persist in LTCF.

To better understand the dimension of the problem of the acquisition of HAI by MDR bacteria during internment at LCTF, this Special Issue aims to bring together research studies related to:

  • Epidemiological surveillance of HAI by MDR bacteria in patients interned at LTCF;
  • Risk factors for the acquisition of HAI during internment at LTCF;
  • Transmission routes of MDR bacteria within LTCF, and between LTCF and other healthcare institutions or community;
  • Molecular epidemiology of MDR bacteria in LTCF;
  • Strategies to control the spread of MDR bacteria in LTCF.

Papers suggesting advanced detection and/or next-generation treatment approaches of these infections are also welcome.

This issue aims to enlarge the available literature regarding the worldwide occurrence of HAI by MDR bacteria in LTCF and the relevance of LTCF as reservoirs of clinically important MDR bacteria.

Dr. Elisabete Machado
Guest Editor

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Keywords

  • multidrug-resistant bacteria
  • healthcare pathogens
  • virulence and resistance
  • long-term care facilities
  • healthcare-associated infections
  • colonization
  • surveillance
  • molecular epidemiology
  • infection control

Published Papers (1 paper)

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Research

14 pages, 1339 KiB  
Article
Occurrence of Healthcare-Associated Infections (HAIs) by Escherichia coli and Klebsiella spp. Producing Extended-Spectrum β-lactamases (ESBL) and/or Carbapenemases in Portuguese Long-Term Care Facilities
by Elisabete Machado, Patrício Costa, Alexandre Carvalho and on behalf of the SAREL Investigators
Pathogens 2022, 11(9), 1019; https://doi.org/10.3390/pathogens11091019 - 07 Sep 2022
Cited by 1 | Viewed by 1487
Abstract
Extended-spectrum-β-lactamase (ESBL)- and carbapenemase-producing bacteria are widespread in hospitals, but the extent of this problem in long-term care facilities (LTCFs) is poorly understood. We aimed to elucidate, in the Portuguese regional clinical context, the relevance of LTCFs as a reservoir of Escherichia coli [...] Read more.
Extended-spectrum-β-lactamase (ESBL)- and carbapenemase-producing bacteria are widespread in hospitals, but the extent of this problem in long-term care facilities (LTCFs) is poorly understood. We aimed to elucidate, in the Portuguese regional clinical context, the relevance of LTCFs as a reservoir of Escherichia coli and Klebsiella spp. producing ESBL- and/or carbapenemases (Ec/Kp-ESBL/CARB). Fourteen LTCFs from Portugal, corresponding to units of convalescence (UC/n = 3), medium-term internment and rehabilitation (UMDR/ n = 5), or long-term internment and maintenance (ULDM/n = 6), were analyzed (2016–2019). All patients with Ec/Kp-ESBL/CARB infections acquired during LTCF stay were included, and detailed information was collected. Prevalence of patients with healthcare-associated infections (HAIs) by Ec/Kp-ESBL/CARB did not vary significantly over time (1.48% in 2016–2017, 1.89% in 2017–2018, and 1.90% in 2018–2019), but a statistically significant association with the LTCF typology (ULDM, UMDR) was observed. HAIs were caused by K. pneumoniae (n = 51/54.3%), E. coli (n = 41/43.6%), or both (n = 2/2.1%), producing ESBL (96%) or carbapenemases (4%). Prior colonization (n = 14/16%) corresponded to seven Kp-CARB and seven Ec/Kp-ESBL. The worrying prevalence of patients acquiring HAIs by Ec/Kp-ESBL/CARB, associated with the estimated rates of those already colonized at admission, highlights a relevant role for LTCFs as a reservoir of Ec/Kp-ESBL/CARB. Epidemiological surveillance should be extended to the national level, and colonization screening at LTCF admission implemented systematically. Full article
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