Prevalence of multiresistant gram-negative bacteria in inhabitants of long-term care facilities in 2019 in Thuringia

Background. Multidrug-resistant gram-negative bacteria (MDRGN) pose an emerging threat in German hospitals and in the outpatient sector. However, only few studies have investigated the prevalence of MDRGN in nonhospital settings and the associated risk factors for colonization. Objective. In our study we determined the prevalence of MDRGN in inhabitants of long-term care facilities (LTCFs) and associated risk factors for colonization in the region Weimar, Weimarer Land, and Jena. Methods. Between May and August 2019, deep rectal swabs were taken from 307 inhabitants of 13 facilities and examined microbiologically for the presence of MDRGN. Furthermore, using a standardized questionnaire, the characteristics of the inhabitants were collected and their association with the likelihood for colonization with MDRGN was analyzed. Results. MDRGN were found in 59 swabs, predominantly Escherichia coli (95%). The weighted prevalence of extended spectrum beta-lactamase-producing bacteria was 19.1% and for MDRGN with additional resistances to fluoroquinolones was 12.3%. Resistances to carbapenems or carbapenemases were not found. Multivariable as well as univariable analysis recognized the presence of chronic wounds to be a potential risk factor (OR: 2,66 [95%-CI: 1,54-4,60]). Additionally, the univariable analysis detected the necessity of a wheelchair and the accommodation in double rooms as risk factors. Discussion. The prevalence of MDRGN found in our study is similar to findings of previous German studies. The result shows the importance of strict compliance with basic hygiene guidelines for all inhabitants of LTCFs for the prevention of transmission of MDRGN.