The prevalence of ESBL-producing Enterobacteriaceae in a nursing home setting compared with elderly living at home: A cross-sectional comparison

Abstract

Background: The aim of the study was to investigate the prevalence of faecal carriage of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae among residents living in nursing homes and to compare it with a corresponding group of elderly people living in their own homes. Methods: A total of 160 persons participated in the study between February and April 2014, 91 were residents in nursing homes (n=10) and the remaining 69 were elderly living in their own homes. In addition to performing faecal samples, all participants answered a standardized questionnaire regarding known risk factors for ESBL-carriage. Results: There was no significant difference between the groups, as 10 of the 91 (11%) residents from nursing homes were ESBL-carriers compared with 6 of 69 (8,7%) elderly living in their own homes. There was no significant difference between the groups. The total prevalence was 10%. A univariate analysis revealed that the only studied risk factor significantly associated with ESBL-carriage was recent foreign travel (p=0,017). All ESBL-positive isolates were Escherichia coli and there was a high degree of co-resistance to other antibiotics. All isolates (n=17) were susceptible to imipenem and amikacin. Conclusion: Residents of nursing homes as well as elderly living in their own homes have high rates of faecal carriage of ESBL-producing bacteria. These findings may affect the choice of empirical antibiotic treatment of severe infections in older adults.