Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa
| dc.contributor.advisor | Wasserman, Sean | |
| dc.contributor.author | September, Jason | |
| dc.date.accessioned | 2020-02-11T11:19:01Z | |
| dc.date.available | 2020-02-11T11:19:01Z | |
| dc.date.issued | 2019 | |
| dc.date.updated | 2020-01-28T12:47:12Z | |
| dc.description.abstract | Objectives Residential care facilities (RCFs) act as reservoirs for multidrug-resistant organisms (MDRO). There are scarce data on colonisation with MDROs in Africa. We aimed to determine the prevalence of MDROs and C. difficile and risk factors for carriage amongst residents of RCFs in Cape Town, South Africa. Methods We performed a cross-sectional surveillance study at three RCFs. Chromogenic agar was used to screen skin swabs for methicillin-resistant Staphylococcus aureus (MRSA) and stool samples for extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E). Antigen testing and PCR was used to detect Clostridiodes difficile. Risk factors for colonisation were determined with logistic regression. Results One hundred fifty-four residents were enrolled, providing 119 stool samples and 152 sets of skin swabs. Twenty-seven (22.7%) stool samples were positive for ESBL-E, and 13 (8.6%) residents had at least one skin swab positive for MRSA. Two (1.6%) stool samples tested positive for C. difficile. Poor functional status (OR 1.3 (95% CI, 1.0 – 1.6)) and incontinence (OR 2.9 (95% CI, 1.2 – 6.9)) were significant predictors for ESBL-E colonisation. There was a trend towards higher MRSA colonisation in frail care areas. Conclusion There was high prevalence of colonisation with MDROs but low C. difficile carriage, with implications for antibiotic prescribing and infection control practice. | |
| dc.identifier.apacitation | September, J. (2019). <i>Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa</i>. (). ,Faculty of Health Sciences ,Department of Medicine. Retrieved from http://hdl.handle.net/11427/31012 | en_ZA |
| dc.identifier.chicagocitation | September, Jason. <i>"Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa."</i> ., ,Faculty of Health Sciences ,Department of Medicine, 2019. http://hdl.handle.net/11427/31012 | en_ZA |
| dc.identifier.citation | September, J. 2019. Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa. | en_ZA |
| dc.identifier.ris | TY - Thesis / Dissertation AU - September, Jason AB - Objectives Residential care facilities (RCFs) act as reservoirs for multidrug-resistant organisms (MDRO). There are scarce data on colonisation with MDROs in Africa. We aimed to determine the prevalence of MDROs and C. difficile and risk factors for carriage amongst residents of RCFs in Cape Town, South Africa. Methods We performed a cross-sectional surveillance study at three RCFs. Chromogenic agar was used to screen skin swabs for methicillin-resistant Staphylococcus aureus (MRSA) and stool samples for extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E). Antigen testing and PCR was used to detect Clostridiodes difficile. Risk factors for colonisation were determined with logistic regression. Results One hundred fifty-four residents were enrolled, providing 119 stool samples and 152 sets of skin swabs. Twenty-seven (22.7%) stool samples were positive for ESBL-E, and 13 (8.6%) residents had at least one skin swab positive for MRSA. Two (1.6%) stool samples tested positive for C. difficile. Poor functional status (OR 1.3 (95% CI, 1.0 – 1.6)) and incontinence (OR 2.9 (95% CI, 1.2 – 6.9)) were significant predictors for ESBL-E colonisation. There was a trend towards higher MRSA colonisation in frail care areas. Conclusion There was high prevalence of colonisation with MDROs but low C. difficile carriage, with implications for antibiotic prescribing and infection control practice. DA - 2019 DB - OpenUCT DP - University of Cape Town KW - Medicine LK - https://open.uct.ac.za PY - 2019 T1 - Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa TI - Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa UR - http://hdl.handle.net/11427/31012 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/31012 | |
| dc.identifier.vancouvercitation | September J. Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa. []. ,Faculty of Health Sciences ,Department of Medicine, 2019 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/31012 | en_ZA |
| dc.language.rfc3066 | eng | |
| dc.publisher.department | Department of Medicine | |
| dc.publisher.faculty | Faculty of Health Sciences | |
| dc.subject | Medicine | |
| dc.title | Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa | |
| dc.type | Master Thesis | |
| dc.type.qualificationlevel | Masters | |
| dc.type.qualificationname | MMed |