Results of an Italian multi-long-term care facilities survey on diagnostic, therapeutic, and infection control topics: state of the art and future perspective

Submitted: 13 February 2024
Accepted: 18 March 2024
Published: 21 May 2024
Abstract Views: 465
PDF: 66
HTML: 8
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Background and Aims: current trends in the world’s demographic structure indicate increasing requirements for chronic and Long-Term Care Facilities (LTCFs). As the above settings may act as reservoirs for Multidrug-Resistant Organisms (MDROs), it is essential to acquire information about diagnostic, therapeutic, and infection control practices, aiming to optimize strategies for the near future. Materials and Methods: the annual survey form for assessment of the MDRO management in LTCFs and Residential Homes (RHs) for non-self-sufficient elderly people, promoted by the Centers for Disease Control (CDC), and adapted by the version of the American National Healthcare Safety Network, was sent to LTCFs healthcare operators by the AMCLI GLISTer Working Group. Topics considered were interactions with clinical microbiology laboratories, infection prevention/control and antibiotic stewardship practices, and electronic medical records data availability. Results and Conclusions: sixteen structures, mostly from 120 to 280 beds, took part in the survey. We registered that i) MDRO colonization screening is usually not adopted in Italian LTCFs for new admissions (14; 87,5%) at present, and ii) microbiological results are usually provided by an external laboratory service. Furthermore, infection control interventions are regularly adopted, and antibiotic prescriptions are registered only in 62,5% and 75% of structures, respectively. About 70% of facilities do not have a strategy for antibiotic use optimization. Planning of 1st/2nd/3rd level MDRO surveillance programs, enhanced training activities, and improved antibiotic consumption control, whether for prophylaxis, empirical, and targeted therapy, appears of paramount importance in the complex reality of LTCFs.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Al Musawi S, Alkhaleefa Q, Alnassri S, et al. Predictive Role of Targeted, Active Surveillance Cultures for Detection of Methicillin-Resistant Staphylococcus aureus. Infect Drug Resist 2021;12:4757-64. DOI: https://doi.org/10.2147/IDR.S340871
Aschbacher R, Pagani L, Migliavacca R, et al. Recommendations for the surveillance of multidrug-resistant bacteria in Italian long-term care facilities by the GLISTer working group of the Italian Association of Clinical Microbiologists (AMCLI). Antimicrob Resist Infect Control 2020;9:106. DOI: https://doi.org/10.1186/s13756-020-00771-0
Bilsen MP, Treep MM, Aantjes MJ, et al. Diagnostic accuracy of urine biomarkers for urinary tract infection in older women: a case-control study. Clin Microbiol Infect 2024;30:216-22. DOI: https://doi.org/10.1016/j.cmi.2023.09.023
Eikelenboom-Boskamp A, Haaijman J, Bos M, et al.. Dutch guideline for preventing nosocomial transmission of highly-resistant micro-organisms (HRMO) in long-term care facilities (LTCFs). Antimicrob Resist Infect Control 2019;27:146. DOI: https://doi.org/10.1186/s13756-019-0586-3
Furmenti MF, Rossello P, Bianco S, et al.. Healthcare-associated infections and antimicrobial use in long-term care facilities (HALT3): an overview of the Italian situation. J Hosp Infect 2019;102:425-30. DOI: https://doi.org/10.1016/j.jhin.2019.02.007
Infectious Diseases Society of America (IDSA), Spellberg B, Blaser M, Guidos RJ, et al. Combating Antimicrobial Resistance: Policy Recommendations to Save Lives. Clin Infect Dis 2011;52:S397-428. DOI: https://doi.org/10.1093/cid/cir153
Nitti MT, Sleghel F, Kaczor M, et al. Colonization of Residents and Staff of an Italian Long-Term Care Facility and an Adjacent Acute Care Hospital Geriatrics Unit by Multidrug-Resistant Bacteria. Microb Drug Resist 2023;29:477-84. DOI: https://doi.org/10.1089/mdr.2023.0019
Ricchizzi E, Latour K, Kärki T, et al. Antimicrobial use in European long-term care facilities: results from the third point prevalence survey of healthcare-associated infections and antimicrobial use, 2016 to 2017. Euro Surveill 2018; 23:1800394. DOI: https://doi.org/10.2807/1560-7917.ES.2018.23.46.1800394
Rodríguez-Villodres A, Martin-Gandul C, Penalva G, et al. Prevalence and Risk Factors for Multidrug-Resistant Organisms Colonization in Long-Term Care Facilities Around the World: A Review. Antibiotics 2021;10;680. DOI: https://doi.org/10.3390/antibiotics10060680
Strausbaugh LJ, Siegel JD, Weinstein RA. Preventing transmission of multidrug-resistant bacteria in health care settings: a tale of 2 guidelines. Clin Infect Dis 2006;15:828-35. DOI: https://doi.org/10.1086/500408
Tinelli M, Tiseo G, Falcone M, et al. Prevention of the spread of multidrug-resistant organisms in nursing homes. Aging Clin Exp Res 2021;33:679-87. DOI: https://doi.org/10.1007/s40520-020-01746-2
van Dulm E, Tholen ATR, Pettersson A, et al. High prevalence of multidrug resistant Enterobacteriaceae among residents of long term care facilities in Amsterdam, the Netherlands. PLoS One 2019;12:e0222200. DOI: https://doi.org/10.1371/journal.pone.0222200

How to Cite

Migliavacca, R., Vaccaro, L., Spalla, M., De Col, A., Aschbacher, R., & working group, G. (2024). Results of an Italian multi-long-term care facilities survey on diagnostic, therapeutic, and infection control topics: state of the art and future perspective. Microbiologia Medica, 39(1). https://doi.org/10.4081/mm.2024.12386