Extended-spectrum β-lactamase-producing Enterobacteriaceae colonisation in long-term care facilities: a systematic review and meta-analysis

Myrto Eleni Flokas, Michail Alevizakos, Fadi Shehadeh, Nikolaos Andreatos, Eleftherios Mylonakis

Research output: Contribution to journalReview articlepeer-review

56 Scopus citations

Abstract

The objectives of this study were to estimate the colonisation rate by extended-spectrum β-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 healthcare facility utilisation. Strict adherence to antimicrobial stewardship in LTCFs is needed to address these high resistance rates.

Original languageEnglish (US)
Pages (from-to)649-656
Number of pages8
JournalInternational Journal of Antimicrobial Agents
Volume50
Issue number5
DOIs
StatePublished - Nov 2017

Keywords

  • Colonisation
  • Extended-spectrum β-lactamase
  • Long-term care facilities
  • Nursing homes

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

Fingerprint

Dive into the research topics of 'Extended-spectrum β-lactamase-producing Enterobacteriaceae colonisation in long-term care facilities: a systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this