Persistent nasal carriers of Acinetobacter baumannii in long-term-care facilities

• Published in: American journal of infection control Vol. 45; no. 7; pp. 723 - 727
• Main Authors: Liou, Ming-Li, Chen, Kuan-Hsueh, Yeh, Hui-Ling, Lai, Chun-Yi, Chen, Chang-Hua
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2017
• Subjects: Acinetobacter baumannii - isolation & purification; Acinetobacter Infections - epidemiology; Adult; Aged; Aged, 80 and over; Carrier state; Carrier State - epidemiology; Community hospitals; Cross-Sectional Studies; Female; Health Personnel; Humans; Infection Control; Infectious Disease; Long-Term Care; Male; Nasal Cavity - microbiology; Prospective Studies; Staphylococcal Infections - epidemiology; Staphylococcus aureus; Staphylococcus aureus - isolation & purification; Taiwan - epidemiology; Young Adult; Community hospitals; Staphylococcus aureus; Carrier state
• ISSN: 0196-6553; 1527-3296; 1527-3296
• DOI: 10.1016/j.ajic.2017.02.005

•A high incidence of nasal carriers for A. baumannii and S. aureus are disclosed in long-term care facilities.•The nasal carriage of A. baumannii and S. aureus in long-term care facilities could represent another origin of transmission in healthcare-associated facilities.•We performed the experiment through IRB-approved protocol for nearly 3 years. Acinetobacter baumannii and Staphylococcus aureus have persisted as 2 major pathogens worldwide. We designed a prevalence study to investigate the prevalence of nasal carriage of S aureus and A baumannii in long-term-care facilities (LCTFs) and their collaborative community hospitals. In addition, we aimed to clarify persistent or nonpersistent carriage of the 2 organisms among residents of LTCFs. We performed a prevalence study concerning nasal carriers of A baumannii and S aureus in 3 LTCFs and 1 collaborative community hospital. Seventy subjects were enrolled and clustered into 3 groups: the elderly sick group (n = 24), the elderly healthy group (n = 33), and the healthy health care worker group (n = 13). Nasal samples were collected, and the nuc and mecA genes of S aureus and the blaOXA gene of A baumannii were analyzed by polymerase chain reaction. Among the 3 groups, the rate of nasal carriage of S aureus was approximately 0%-15%. However, the rate for A baumannii was approximately 54%-92%. Notably, the persistent carrier rate of A baumannii in the elderly sick group was 83.3% (20 out of 24) despite a 12.5% (3 out of 24) rate of carbapenem-resistant A baumannii. We emphasized that the persistent nasal carriage of A baumannii in LTCFs could be another portal of exit to cause A baumannii infection in Taiwan.