Multiresistant bacteria posing a problem for the aged
Infectious diseases experts are concerned about a high prevalence of multiresistant E. coli in residential aged care residents, according to the authors of a study published in the 7 November issue of the Medical Journal of Australia.
The study authors said that in hospital settings, patients with multiresistant gram-negative bacteria are placed in contact isolation to limit spread of the organisms, but this was difficult to achieve in residential aged care facilities (RACFs) because residents usually share dining rooms and recreation areas.
Environmental contamination and poor hand hygiene were also likely to contribute to the spread of the bacteria, while increased use of antibiotics is associated with the development of resistance, the authors said.
Escherichia coli colonisation was detected in 12 per cent of the 119 residents screened in three Australian facilities in October and November 2010, with half of these infected residents living in the same wing of one facility. Eight of 13 residents had persistent colonisation on repeat testing three months later.
“Antimicrobial resistance in RACFs is of growing concern,” said lead author Dr Rhonda Stuart, Medical Director of Infection Control and Epidemiology at Monash Medical Centre.
“RACFs should have programs emphasising processes that will limit spread of these organisms, namely good hand hygiene compliance, enhanced environmental cleaning, and dedicated antimicrobial stewardship programs.”
In an accompanying MJA editorial, medical microbiologist Timothy Inglis and geriatrician Christopher Beer said a control method for multiresistant bacteria that relies on surveillance and targeted infection control measures may seem appealing but in reality is likely to be “costly, impractical and ineffective”.
“An alternative strategy is to use multiple measures targeting improvements in the skilled nursing care of those at identifiably higher risk of multiresistant bacterial infection, without prior surveillance culture,” they said.
The Medical Journal of Australia is a publication of the Australian Medical Association.
The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.
CONTACTS: Dr Timothy Inglis 04047 994 631
Ms Suzana Talevski 0409 023 936
Monash Media unit (on behalf of Dr Rhonda Stuart)
