Program Schedule

346
Longterm carriage of Ciprofloxacin-Resistant E. Coli Isolates among Nursing Home (NH) Residents

Session: Poster Abstract Session: Multidrug-resistant Organisms: Epidemiology and Prevention
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • TIP PosterFINAL.pdf (632.5 kB)
  • Background: With the pervasive use of quinolones, quinolone-resistant gram negative bacteria are increasingly common in NHs.  However, there are few estimates of the duration of carriage of resistant strains, the extent colonized individuals carry the same strain at multiple sites, and the proportion of strains shared among residents. We begin to fill these gaps using samples from the Targeted Infection Prevention (TIP) Study. 

    Methods: We used REP-PCR to type 86 ciprofloxacin-resistant E. coli isolates collected during monthly surveillance of 21 individuals with medical devices over a 1 year period in a single NH.  Isolates were collected from multiple body sites at each time point and screened for antibiotic susceptibility against ciprofloxacin.  REP-PCR amplification was performed on all isolates using (GTG)5-primers; isolates from the same individual were run on the same gel.  To check if isolates were shared among individuals, a representative strain from each type was sampled from each individual and run on a single gel.  Strains with the identical banding pattern were considered the same. 

    Results: Most isolates were from the rectum (49%) and the groin (24%).  Nine unique REP-PCR-types were observed; 4 individuals (19%) carried at least two genetically unique strains. The median duration of carriage for a single strain was 28 days (range, 1-338 days).   One REP -PCR type was found in 7 residents and two among 4 residents; 3 REP-PCR types were found on only one resident suggesting substantial transmission among residents.  

    Conclusion:

    Colonized NH residents tended to carry the same ciprofloxacin-resistant E. coli strain at multiple body sites and for long periods.  90% of REP -PCR types were found in multiple/at least two individuals suggesting that the risk of transmission of resistant strains of E. coli is high in NH.

    Miriam Ismail, MPH1, Ting Luo, MPH1, Usha Srinivasan, PhD2, Lona Mody, MD, MSc3, Sara Mcnamara, MT(ASCP), MPH4, Bonnie Lansing5 and Betsy Foxman, PhD2, (1)Epidemiology, University of Michigan, Ann Arbor, MI, (2)Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, (3)Department of Internal Medicine, Division of General Medicine, University of Michigan Medical School, Ann Arbor, MI, (4)Department of Internal Medicine, Division of Geriatric Medicine, University of Michigan Medical School, Ann Arbor, MI, (5)Geriatrics, University of Michigan, Ann Arbor, MI

    Disclosures:

    M. Ismail, None

    T. Luo, None

    U. Srinivasan, None

    L. Mody, None

    S. Mcnamara, University of Michigan - Geriatrics: Employee, Salary
    AHRQ: Collaborator, Salary and staff member on AHRQ grants and contracts
    NIH : Collaborator, Salary and staff member on NIH grants and contracts of Dr. Mody

    B. Lansing, None

    B. Foxman, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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