Header

UZH-Logo

Maintenance Infos

Antibiotic resistance in Swiss nursing homes: analysis of National Surveillance Data over an 11-year period between 2007 and 2017


Kohler, Philipp; Fulchini, Rosamaria; Albrich, Werner C; Egli, Adrian; Balmelli, Carlo; Harbarth, Stephan; Héquet, Delphine; Kahlert, Christian R; Kuster, Stefan P; Petignat, Christiane; Schlegel, Matthias; Kronenberg, Andreas (2018). Antibiotic resistance in Swiss nursing homes: analysis of National Surveillance Data over an 11-year period between 2007 and 2017. Antimicrobial Resistance and Infection Control, 7:88.

Abstract

Background
We evaluated data from isolates of nursing home (NH) patients sent to the Swiss centre for antibiotic resistance (ANRESIS). We focussed on carbapenem-resistance (CR) among Gram-negative pathogens, extended-spectrum cephalosporin-resistant (ESC-R) /, methicillin-resistant (MRSA), and glycopeptide-resistant enterococci (GRE).

Methods
NH patient isolates from 01/2007 to 10/2017 were extracted. Temporal trends in resistance were described and risk factors associated with ESC-R and MRSA were assessed. For every administrative subdivision in Switzerland (i.e. canton), we calculated a coverage rate, defined as number of beds of governmentally-supported nursing homes, which sent ≥1 isolate in each 2014, 2015, and 2016, divided by the total number of supported beds.

Results
We identified 16'804 samples from 9'940 patients. A majority of samples (12'040; 71.6%) originated from the French/Italian speaking part of Switzerland. ESC-R increased from 5% (16/299) in 2007 to 22% (191/884) in 2017 ( < 0.01), whereas MRSA decreased from 34% (35/102) to 26% (21/81) ( < 0.01). Provenience from the German (vs. French/Italian) speaking part of Switzerland was associated with decreased risk for ESC-R (OR 0.5, 95% CI 0.4-0.7) and for MRSA (OR 0.1, 95% CI 0.1-0.2). CR among was 10% (105/1096) and showed an increasing trend over time; CR among (37/12'423, 0.3%) and GRE (5/1'273, 0.4%) were uncommon. Overall coverage rate was 9% (range 0-58% per canton). There was a significant difference between the French/Italian (median 13%, interquartile range [IQR] 4-43%) and the German speaking cantons (median 0%, IQR 0-5%) ( = 0.02).

Conclusions
ESC-R among is emerging in Swiss NHs, whereas MRSA show a declining trend over time. A minority of NHs are represented in ANRESIS, with a preponderance of institutions from the French/Italian speaking regions. Efforts should be undertaken to improve resistance surveillance in this high-risk setting.

Abstract

Background
We evaluated data from isolates of nursing home (NH) patients sent to the Swiss centre for antibiotic resistance (ANRESIS). We focussed on carbapenem-resistance (CR) among Gram-negative pathogens, extended-spectrum cephalosporin-resistant (ESC-R) /, methicillin-resistant (MRSA), and glycopeptide-resistant enterococci (GRE).

Methods
NH patient isolates from 01/2007 to 10/2017 were extracted. Temporal trends in resistance were described and risk factors associated with ESC-R and MRSA were assessed. For every administrative subdivision in Switzerland (i.e. canton), we calculated a coverage rate, defined as number of beds of governmentally-supported nursing homes, which sent ≥1 isolate in each 2014, 2015, and 2016, divided by the total number of supported beds.

Results
We identified 16'804 samples from 9'940 patients. A majority of samples (12'040; 71.6%) originated from the French/Italian speaking part of Switzerland. ESC-R increased from 5% (16/299) in 2007 to 22% (191/884) in 2017 ( < 0.01), whereas MRSA decreased from 34% (35/102) to 26% (21/81) ( < 0.01). Provenience from the German (vs. French/Italian) speaking part of Switzerland was associated with decreased risk for ESC-R (OR 0.5, 95% CI 0.4-0.7) and for MRSA (OR 0.1, 95% CI 0.1-0.2). CR among was 10% (105/1096) and showed an increasing trend over time; CR among (37/12'423, 0.3%) and GRE (5/1'273, 0.4%) were uncommon. Overall coverage rate was 9% (range 0-58% per canton). There was a significant difference between the French/Italian (median 13%, interquartile range [IQR] 4-43%) and the German speaking cantons (median 0%, IQR 0-5%) ( = 0.02).

Conclusions
ESC-R among is emerging in Swiss NHs, whereas MRSA show a declining trend over time. A minority of NHs are represented in ANRESIS, with a preponderance of institutions from the French/Italian speaking regions. Efforts should be undertaken to improve resistance surveillance in this high-risk setting.

Statistics

Citations

Dimensions.ai Metrics
2 citations in Web of Science®
2 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

6 downloads since deposited on 24 Aug 2018
6 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2018
Deposited On:24 Aug 2018 11:48
Last Modified:31 Aug 2018 23:52
Publisher:BioMed Central
ISSN:2047-2994
OA Status:Gold
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1186/s13756-018-0378-1
PubMed ID:30038781

Download

Download PDF  'Antibiotic resistance in Swiss nursing homes: analysis of National Surveillance Data over an 11-year period between 2007 and 2017'.
Preview
Content: Published Version
Filetype: PDF
Size: 1MB
View at publisher
Licence: Creative Commons: Attribution 4.0 International (CC BY 4.0)