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Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa
Objectives Residential care facilities (RCFs) act as reservoirs for multidrug-resistant organisms (MDRO). There are scarce data on colonisation with MDROs in Africa. We aimed to determine the prevalence of MDROs and C. difficile and risk factors for carriage amongst residents of RCFs in Cape Town,...
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
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Department of Medicine
2020
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| _version_ | 1867613759878463488 |
|---|---|
| access_status_str | Open Access |
| author | September, Jason |
| author2 | Wasserman, Sean |
| author_browse | September, Jason Wasserman, Sean |
| author_facet | Wasserman, Sean September, Jason |
| author_sort | September, Jason |
| collection | Thesis |
| description | Objectives
Residential care facilities (RCFs) act as reservoirs for multidrug-resistant organisms (MDRO). There are scarce data on colonisation with MDROs in Africa. We aimed to determine the prevalence of MDROs and C. difficile and risk factors for carriage amongst residents of RCFs in Cape Town, South Africa.
Methods
We performed a cross-sectional surveillance study at three RCFs. Chromogenic agar was used to screen skin swabs for methicillin-resistant Staphylococcus aureus (MRSA) and stool samples for extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E). Antigen testing and PCR was used to detect Clostridiodes difficile. Risk factors for colonisation were determined with logistic regression.
Results
One hundred fifty-four residents were enrolled, providing 119 stool samples and 152 sets of skin swabs. Twenty-seven (22.7%) stool samples were positive for ESBL-E, and 13 (8.6%) residents had at least one skin swab positive for MRSA. Two (1.6%) stool samples tested positive for C. difficile. Poor functional status (OR 1.3 (95% CI, 1.0 – 1.6)) and incontinence (OR 2.9 (95% CI, 1.2 – 6.9)) were significant predictors for ESBL-E colonisation. There was a trend towards higher MRSA colonisation in frail care areas.
Conclusion
There was high prevalence of colonisation with MDROs but low C. difficile carriage, with implications for antibiotic prescribing and infection control practice. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/31012 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:41:15.763Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | Department of Medicine |
| publisherStr | Department of Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/31012 Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa September, Jason Wasserman, Sean Medicine Objectives Residential care facilities (RCFs) act as reservoirs for multidrug-resistant organisms (MDRO). There are scarce data on colonisation with MDROs in Africa. We aimed to determine the prevalence of MDROs and C. difficile and risk factors for carriage amongst residents of RCFs in Cape Town, South Africa. Methods We performed a cross-sectional surveillance study at three RCFs. Chromogenic agar was used to screen skin swabs for methicillin-resistant Staphylococcus aureus (MRSA) and stool samples for extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E). Antigen testing and PCR was used to detect Clostridiodes difficile. Risk factors for colonisation were determined with logistic regression. Results One hundred fifty-four residents were enrolled, providing 119 stool samples and 152 sets of skin swabs. Twenty-seven (22.7%) stool samples were positive for ESBL-E, and 13 (8.6%) residents had at least one skin swab positive for MRSA. Two (1.6%) stool samples tested positive for C. difficile. Poor functional status (OR 1.3 (95% CI, 1.0 – 1.6)) and incontinence (OR 2.9 (95% CI, 1.2 – 6.9)) were significant predictors for ESBL-E colonisation. There was a trend towards higher MRSA colonisation in frail care areas. Conclusion There was high prevalence of colonisation with MDROs but low C. difficile carriage, with implications for antibiotic prescribing and infection control practice. 2020-02-11T11:19:01Z 2020-02-11T11:19:01Z 2019 2020-01-28T12:47:12Z Master Thesis Masters MMed http://hdl.handle.net/11427/31012 eng application/pdf Department of Medicine Faculty of Health Sciences |
| spellingShingle | Medicine September, Jason Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa |
| thesis_degree_str | Master's |
| title | Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa |
| title_full | Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa |
| title_fullStr | Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa |
| title_full_unstemmed | Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa |
| title_short | Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa |
| title_sort | colonisation with pathogenic drug resistant bacteria and clostridioides difficile among residents of residential care facilities in cape town south africa |
| topic | Medicine |
| url | http://hdl.handle.net/11427/31012 |
| work_keys_str_mv | AT septemberjason colonisationwithpathogenicdrugresistantbacteriaandclostridioidesdifficileamongresidentsofresidentialcarefacilitiesincapetownsouthafrica |