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Social and clinical predictors of perianal colonisation by multidrug-resistant bacteria for geriatric patients in the internal medicine service

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Abstract

Background

Colonisation by multidrug-resistant (MDR) bacteria is a global health issue. The identification of patients with a higher risk of colonisation is essential. Patients admitted to internal medicine services might represent a vulnerable population with a high risk of colonisation. This study was the first to assess social and clinical variables associated with a higher risk of perianal colonisation by MDR bacteria in a Spanish cohort of patients admitted to internal medicine service.

Methods

Patients admitted to an internal medicine service during 12 months of recruitment (1 March 2022 to 1 March 2023) were included in the study. Perianal swabs were performed at admission to identify the presence of MDR bacteria. Social and clinical variables were collected following a directed acyclic graph. A cluster analysis was performed to identify clinical profiles of higher risk. Bivariate analyses and multivariable logistic regression models were fitted to identify potential predictors of MDR bacteria colonisation.

Results

A total of 245 patients, according to the required sample size, were included. Of them, 46 (18.8%) were colonised by MDR bacteria in perianal swabs. Female sex, age > 80 years, dependency on activities of daily living, cognitive deterioration and living in long-term care facilities constituted the highest risk clinical profile. After adjustments, living in long-term care facilities and malnutrition remained the main risk factors identified.

Conclusion

Patients admitted to internal medicine services presented a high frequency of perianal colonisation by MDR bacteria. Social and clinical variables associated with bio-psycho-social susceptibility were associated with colonisation. Special surveillance is needed in internal medicine services to control the transmission.

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Data availability

Anonymous raw data from this study can be shared upon reasonable request from the corresponding author.

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Acknowledgements

We wish to acknowledge all personnel of internal medicine service of the Hospital Universitario San Cecilio for their predisposition, for the collecting of rectal swab samples and for the facilities they have provided for the correct development of this work.

Funding

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Authors and Affiliations

  1. Service of Preventive Medicine and Public Health, Hospital Universitario San Cecilio, Avenida de la Investigación s/n, 18016, Granada, Spain

    María del Carmen Valero-Ubierna, Javier Pérez de Rojas, Cristina García-Marín, José Juan Jiménez-Moleón & Mario Rivera-Izquierdo

  2. Service of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain

    Alberto Benavente-Fernández, Fidel Moreno-Verdejo, Jairo López-Gómez & Sergio Fernández-Ontiveros

  3. Service of Microbiology, Hospital Universitario San Cecilio, Granada, Spain

    Natalia Chueca-Porcuna

  4. Instituto Biosanitario de Granada (ibs.GRANADA), Granada, Spain

    Natalia Chueca-Porcuna, José Juan Jiménez-Moleón & Mario Rivera-Izquierdo

  5. CIBERINFEC - Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain

    Natalia Chueca-Porcuna

  6. Service of Preventive Medicine and Public Health, Hospital Universitario La Paz, Madrid, Spain

    Cristina García-Marín

  7. CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

    José Juan Jiménez-Moleón & Mario Rivera-Izquierdo

Authors
  1. María del Carmen Valero-Ubierna
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  2. Alberto Benavente-Fernández
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  3. Javier Pérez de Rojas
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  7. Natalia Chueca-Porcuna
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  8. Cristina García-Marín
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  9. José Juan Jiménez-Moleón
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  10. Mario Rivera-Izquierdo
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Contributions

MCV, AB, JJJ and MR designed the study. JPR and MR performed the statistical analysis. MCV and MR wrote the first draft of the manuscript. MCV, AB, JPR, FM, JL, SF, NC, CG, JJJ and MR collected the raw data and critically revised the design of the study. All authors reviewed and approved the final version of the manuscript.

Corresponding author

Correspondence to Mario Rivera-Izquierdo.

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Conflict of interest

All authors have completed the ICMJE uniform disclosure form at https://www.icmje.org/coi_disclosure.pdf and declare: no support from any organisation for the submitted work.

Ethical approval and consent to participate

This study was approved by the Provincial Ethical Committee of Granada on 22 February 2022, code MR_161121.

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Not applicable.

Supplementary Information

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del Carmen Valero-Ubierna, M., Benavente-Fernández, A., Pérez de Rojas, J. et al. Social and clinical predictors of perianal colonisation by multidrug-resistant bacteria for geriatric patients in the internal medicine service. Infection 52, 231–241 (2024). https://doi.org/10.1007/s15010-023-02153-1

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