Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study

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dc.contributor.authorSeptember, Jason
dc.contributor.authorGeffen, Leon
dc.contributor.authorManning, Kathryn
dc.contributor.authorNaicker, Preneshni
dc.contributor.authorFaro, Cheryl
dc.contributor.authorMendelson, Marc
dc.contributor.authorWasserman, Sean
dc.date.accessioned2019-12-10T08:49:33Z
dc.date.available2019-12-10T08:49:33Z
dc.date.issued2019-11-19
dc.date.updated2019-11-24T04:47:01Z
dc.description.abstractAbstract Background 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 S. aureus (MRSA) and stool samples for extended-spectrum beta-lactamase-producing Enterobacteriaceae (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. MRSA colonization appeared higher in frail care areas (8/58 v 5/94, p = 0.07). Conclusions There was a relatively high prevalence of colonisation with MDROs, particularly ESBL-E, but low C. difficile carriage, with implications for antibiotic prescribing and infection control practice.
dc.identifier.apacitationSeptember, J., Geffen, L., Manning, K., Naicker, P., Faro, C., Mendelson, M., & Wasserman, S. (2019). Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study. http://hdl.handle.net/11427/30664en_ZA
dc.identifier.chicagocitationSeptember, Jason, Leon Geffen, Kathryn Manning, Preneshni Naicker, Cheryl Faro, Marc Mendelson, and Sean Wasserman "Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study." (2019) http://hdl.handle.net/11427/30664en_ZA
dc.identifier.citationAntimicrobial Resistance & Infection Control. 2019 Nov 19;8(1):180
dc.identifier.ris TY - Journal Article AU - September, Jason AU - Geffen, Leon AU - Manning, Kathryn AU - Naicker, Preneshni AU - Faro, Cheryl AU - Mendelson, Marc AU - Wasserman, Sean AB - Abstract Background 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 S. aureus (MRSA) and stool samples for extended-spectrum beta-lactamase-producing Enterobacteriaceae (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. MRSA colonization appeared higher in frail care areas (8/58 v 5/94, p = 0.07). Conclusions There was a relatively high prevalence of colonisation with MDROs, particularly ESBL-E, but low C. difficile carriage, with implications for antibiotic prescribing and infection control practice. DA - 2019-11-19 DB - OpenUCT DP - University of Cape Town KW - Residential care facility KW - Antibiotic resistance KW - C. difficile KW - Colonization KW - MRSA KW - ESBL KW - Infection control KW - Antibiotic stewardship 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: a cross-sectional prevalence study TI - Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study UR - http://hdl.handle.net/11427/30664 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s13756-019-0643-y
dc.identifier.urihttp://hdl.handle.net/11427/30664
dc.identifier.vancouvercitationSeptember J, Geffen L, Manning K, Naicker P, Faro C, Mendelson M, et al. Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study. 2019; http://hdl.handle.net/11427/30664.en_ZA
dc.language.rfc3066en
dc.rights.holderThe Author(s).
dc.subjectResidential care facility
dc.subjectAntibiotic resistance
dc.subjectC. difficile
dc.subjectColonization
dc.subjectMRSA
dc.subjectESBL
dc.subjectInfection control
dc.subjectAntibiotic stewardship
dc.titleColonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study
dc.typeJournal Article
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