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Multidrug-Resistant, Gram-Negative Bacteria in Hospitalized Elderly Patients from Non-Hospital Long-Term Care Facilities

대한내과학회지 2019년 94권 1호 p.107 ~ 113
김민성 ( Kim Min-Sung ) - 서울특별시 서울의료원 내과

신진호 ( Shin Jin-Ho ) - 서울특별시 서울의료원 내과
정연상 ( Jeong Yeon-Sang ) - 서울특별시 서울의료원 내과
조진경 ( Cho Jin-Kyeong ) - 서울특별시 서울의료원 내과
최재필 ( Choi Jae-Phil ) - 서울특별시 서울의료원 내과

Abstract


Background/Aims: We investigated the risk of multidrug-resistant, gram-negative bacteria (MDRGNB) in hospitalized elderly patients from non-hospital long-term care facilities (LTCFs) and the antibiotic prescription pattern.

Methods: All clinical cultures obtained within 48 hours of hospitalization from elderly patients of at least 55 years of age arriving at a 623-bed, public teaching hospital in Seoul, Republic of Korea from LTCFs between April 1, 2011 and April 1, 2012 were collected retrospectively.

Results: During this period, 365 elderly persons from 13 LTCFs were hospitalized. This study enrolled 135 patients who had cultures performed. In this group, 27.4% harbored MDRGNB at hospitalization. The presence of MDRGNB during prior hospitalization was the only risk factor that predicted harboring it (p = 0.043, odds ratio = 5.00, confidence interval = 1.049-23.834). Combinations of antibiotics or carbapenems were used initially in 35.6% of the patients, and this did not affect the mortality rate in this population.

Conclusions: Hospitalized elderly patients from non-hospital LTCFs need more attention. Judicious antibiotic selection is needed according to the risk factor of harboring MDRGNB for antibiotics stewardship.

키워드

Long-term care; Aged; Drug resistance, Multiple, Bacterial
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