Gut microbiology of UK care home residents : a cross-sectional analysis from a randomised controlled trial
Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved..
OBJECTIVE: To describe the prevalence of potentially clinically relevant gut pathogens and associations with the carriage of resistant organisms in UK care home residents.
METHODS: Stool samples were collected pre-randomisation from care home residents participating in a randomised placebo-controlled trial. Cultivable clinically relevant bacteria were analysed. Antimicrobial susceptibility testing was performed by agar dilution (amoxicillin, co-amoxiclav, gentamicin, trimethoprim, nitrofurantoin, and ciprofloxacin). We also aimed to detect resistance to third-generation cephalosporins, carbapenems, and vancomycin.
RESULTS: Stool samples were available for 159/310 residents participating in the trial (51%) from 23 care homes between 2016 and 2018. In total, 402 bacterial isolates were cultured from 158 stool samples and 29 different species were cultured. The five most common species were Escherichia coli (155/158, 98%), Pseudomonas aeruginosa (40/158, 25%), Enterococcus faecalis (35/158, 22%), Enterococcus faecium (30/158, 19%), and Proteus mirabilis (25/158, 16%). Enterobacterales isolates were cultured from 157 samples (99%), and resistance to at least one of the tested antimicrobials was found in 119 of these (76%). There were high levels of variation in outcomes by care home.
DISCUSSION: We demonstrated that care home residents harbour significant levels of antimicrobial-resistant organisms in their stool. This work emphasises the importance of both enhanced infection control practices and antimicrobial stewardship programmes to support the appropriate use of antimicrobials in this setting.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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| Enthalten in: |
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases - (2023) vom: 17. Aug. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gillespie, David [VerfasserIn] |
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| Links: |
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| Themen: |
Antimicrobial resistance |
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| Anmerkungen: |
Date Revised 24.08.2023 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.cmi.2023.08.001 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM360945899 |
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| 100 | 1 | |a Gillespie, David |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Gut microbiology of UK care home residents |b a cross-sectional analysis from a randomised controlled trial |
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| 500 | |a Date Revised 24.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVE: To describe the prevalence of potentially clinically relevant gut pathogens and associations with the carriage of resistant organisms in UK care home residents | ||
| 520 | |a METHODS: Stool samples were collected pre-randomisation from care home residents participating in a randomised placebo-controlled trial. Cultivable clinically relevant bacteria were analysed. Antimicrobial susceptibility testing was performed by agar dilution (amoxicillin, co-amoxiclav, gentamicin, trimethoprim, nitrofurantoin, and ciprofloxacin). We also aimed to detect resistance to third-generation cephalosporins, carbapenems, and vancomycin | ||
| 520 | |a RESULTS: Stool samples were available for 159/310 residents participating in the trial (51%) from 23 care homes between 2016 and 2018. In total, 402 bacterial isolates were cultured from 158 stool samples and 29 different species were cultured. The five most common species were Escherichia coli (155/158, 98%), Pseudomonas aeruginosa (40/158, 25%), Enterococcus faecalis (35/158, 22%), Enterococcus faecium (30/158, 19%), and Proteus mirabilis (25/158, 16%). Enterobacterales isolates were cultured from 157 samples (99%), and resistance to at least one of the tested antimicrobials was found in 119 of these (76%). There were high levels of variation in outcomes by care home | ||
| 520 | |a DISCUSSION: We demonstrated that care home residents harbour significant levels of antimicrobial-resistant organisms in their stool. This work emphasises the importance of both enhanced infection control practices and antimicrobial stewardship programmes to support the appropriate use of antimicrobials in this setting | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antimicrobial resistance | |
| 650 | 4 | |a Gut microbiology | |
| 650 | 4 | |a Long-term care facilities | |
| 650 | 4 | |a United Kingdom | |
| 700 | 1 | |a Wootton, Mandy |e verfasserin |4 aut | |
| 700 | 1 | |a Ray, Ruby |e verfasserin |4 aut | |
| 700 | 1 | |a Calder, Philip C |e verfasserin |4 aut | |
| 700 | 1 | |a Mandy Lau, Tin Man |e verfasserin |4 aut | |
| 700 | 1 | |a Owen-Jones, Eleri |e verfasserin |4 aut | |
| 700 | 1 | |a Lowe, Rachel |e verfasserin |4 aut | |
| 700 | 1 | |a Davies, Leanne |e verfasserin |4 aut | |
| 700 | 1 | |a Richards, Jennifer |e verfasserin |4 aut | |
| 700 | 1 | |a Hood, Kerenza |e verfasserin |4 aut | |
| 700 | 1 | |a Castro-Herrera, Vivian |e verfasserin |4 aut | |
| 700 | 1 | |a Davies, Jane |e verfasserin |4 aut | |
| 700 | 1 | |a Francis, Nick A |e verfasserin |4 aut | |
| 700 | 1 | |a Hobbs, F D Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Lown, Mark |e verfasserin |4 aut | |
| 700 | 1 | |a Moore, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Shepherd, Victoria |e verfasserin |4 aut | |
| 700 | 1 | |a Butler, Christopher C |e verfasserin |4 aut | |
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