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Background: With the global increase in the older population, the proportion of those receiving care in long-term care facilities (LTCFs) has also been increasing. We assessed the epidemiology, antibiotic susceptibility, and colonization status of drug-resistant organisms in patients transferred from LTCFs.
Methods: We retrospectively reviewed the medical records of patients transferred from LTCFs between 2017 and 2022. The reasons for admission, antimicrobial susceptibility, and colonization rates of carbapenem-resistant Enterobacterales (CRE), methicillin-resistant Staphylococcus aureus (MRSA), and carbapenem-resistant Acinetobacter baumannii (CRAB) were recorded. We analyzed the susceptibility and colonization rates by year to identify trends.
Results: Of the 936 patients transferred from LTCFs, 54.3% were admitted to the intensive care unit and 12.5% died. The most common reason for admission was infection (n = 573, 61.2%), followed by gastrointestinal bleeding (n = 67, 7.2%) and cerebrovascular disorder (n = 65, 6.9%). A total of 452 Enterobacterales strains were isolated, and their susceptibility rates to ciprofloxacin and cefotaxime were 33.3% and 35.6%, respectively. A total of 54.9% were extended-spectrum beta-lactamase-producing strains, and 4.9% of them were carbapenem-resistant, both of which showed an increasing trend (P = 0.024 and P < 0.001, respectively). The prevalence rates of CRE, CRAB, and MRSA colonization were 9.2%, 7.1%, and 23.1%, respectively. CRE colonization showed a significant increase (P < 0.001), with carbapenemase-producing Enterobacterales accounting for 75.9% of cases.
Conclusions: Patients transferred from LTCFs are primarily affected by infections and exhibit high resistance rates. The increasing trend in CRE colonization rates each year highlights the need for the implementation of rigorous infection control measures for effective management.
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http://dx.doi.org/10.1186/s12879-024-09145-y | DOI Listing |
Ann Palliat Med
September 2025
Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Background: Delirium is a common condition at the end of life and causes significant distress in patients and their loved ones. A precipitant factor can be found in less than half of the patients and the management interventions are limited.
Case Description: A patient in his late sixties with low English proficiency with a metastatic neuroendocrine tumor was transferred to a palliative care unit on non-invasive bilevel ventilation.
Wounds
August 2025
Solventum, Maplewood, MN, USA.
Background: Initially limited to inpatient use, negative pressure wound therapy (NPWT) is now frequently used in community settings. However, complexities in wound management step-down strategies in the United Kingdom, including regional variations in referral processes, lack of consensus on funding criteria, and limited availability of NPWT units, have led to extended hospital length of stay (LOS) for patients ready for discharge but still needing NPWT. Single-use NPWT (sNPWT) can serve as a bridge between hospital and community NPWT.
View Article and Find Full Text PDFViolence Vict
September 2025
University of South Alabama Health System, Mobile, AL, USA.
This study examined the implementation of a state law in the southern United States that required hospitals to report gunshot wounds (GSWs) to law enforcement by exploring changes in the proportion of reported GSW cases in a level 1 trauma center. In the first year of implementation, 95.7% of the GSW admissions who arrived via a private vehicle or walked in were reported to law enforcement; this decreased to 71.
View Article and Find Full Text PDFHeart
September 2025
Kingston University, London, UK.
Importance/background: The 12-lead ECG is recommended in clinical guidelines for prehospital assessment of patients with suspected acute coronary syndrome (ACS) presenting to Emergency Medical Services (EMS).
Objectives: To determine prehospital ECG (PHECG) utilisation since UK national rollout of primary percutaneous coronary intervention, and whether this is associated with clinical outcomes in patients with ACS.
Design: Population-based, linked cohort study using Myocardial Ischaemia National Audit Project data from 1 January 2010 to 31 December 2017, related to patients with ACS conveyed by the EMS to hospital in England and Wales.
BMJ Open
September 2025
Department of Gastroenterology, Hepatology, Infectious Diseases and Intoxication, University Hospital Heidelberg, Heidelberg, Germany.
Introduction: Combined vascular endothelial growth factor/programmed death-ligand 1 blockade through atezolizumab/bevacizumab (A/B) is the current standard of care in advanced hepatocellular carcinoma (HCC). A/B substantially improved objective response rates compared with tyrosine kinase inhibitor sorafenib; however, a majority of patients will still not respond to A/B. Strong scientific rationale and emerging clinical data suggest that faecal microbiota transfer (FMT) may improve antitumour immune response on PD-(L)1 blockade.
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