Evidence map›Paper›PMID 29304069›Full record

Observational studyPloS one2018

Naso- and oropharyngeal bacterial carriage in nursing home residents: Impact of multimorbidity and functional impairment.

Anja Kwetkat, Wolfgang Pfister, Diana Pansow, Mathias W Pletz, Cornel C Sieber, Heike Hoyer

Open access · goldAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 14 citations in OpenAlex.

  1. Observational
  2. Article
  3. Review
  4. Article
  5. Molecular Epidemiology ofAntibiotics (Basel, Switzerland) · 2022
    Article
  6. Review
  7. Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Anja KwetkatDepartment of Geriatric Medicine, Jena University Hospital, Jena, Thuringia, Germany.ORCID 0000-0003-1931-4328
Wolfgang PfisterInstitute of Medical Microbiology, Jena University Hospital, Jena, Thuringia, Germany.
Diana PansowDepartment of Geriatric Medicine, Jena University Hospital, Jena, Thuringia, Germany.
Mathias W PletzCentre for Infectious Diseases and Infection's Control, Jena University Hospital, Jena, Thuringia, Germany.
Cornel C SieberInstitute of Biomedicine of Ageing, Friedrich-Alexander University Erlangen-Nuremberg, Nuremberg, Bavaria, Germany.
Heike HoyerInstitute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Jena, Thuringia, Germany.
Jena University Hospital · DEFriedrich-Alexander-Universität Erlangen-Nürnberg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveFrom April 2013 to February 2014 we performed a multicentre prospective cross-sectional study in 541 German nursing home residents. We determined pharyngeal carriage of Streptococcus pneumoniae (primary objective) and other bacteria (secondary objective) in naso- and oropharyngeal swabs by culture-based standard procedures and explored the influence of multimorbidity and functional status on bacterial carriage.

methodsSocio-demographic data, vaccination status, multimorbidity, nutrition and functional status defined by Comprehensive Geriatric Assessment were evaluated. We estimated carriage rates with 95% confidence intervals (CI) and explored potential risk factors by logistic regression analysis.

resultsPneumococcal post-serotyping carriage rate was 0.8% (95%CI 0.2-1.9%; 4/526). Serotyping revealed serotypes 4, 7F, 23B and 23F and S. pseudopneumoniae in two other cases. Odds of carriage were higher in men (Odds ratio OR 5.3 (95%CI 0.9-29.4)), in malnourished residents (OR 4.6 (0.8-25.7)), residents living in shared rooms (OR 3.0 (0.5-16.5)) or having contact with schoolchildren (OR 2.0 (0.2-17.6)). The most frequent pathogen was Staphylococcus aureus (prevalence 29.5% (25.6-33.6%)) with meticillin-resistant Staphylococcus aureus prevalence of 1.1%. Gram-negative bacteria (GNB) were found in 22.5% (19.0-26.3%) with a prevalence of extended-spectrum beta lactamase (ESBL) producing bacteria of 0.8%. Odds of S. aureus carriage were higher for immobility (OR 1.84 (1.15-2.93)) and cognitive impairment (OR 1.54 (0.98-2.40)). Odds of GNB carriage were higher in residents with more severe comorbidity (OR 1.13 (1.00-1.28)) and malnutrition (OR 1.54 (0.81-2.91)).

conclusionsGiven the observed data, at least long-term carriage of S. pneumoniae in nursing home residents seems to be rare and rather unlikely to cause nursing home acquired pneumonia. The low rate of colonization with multi drug resistant (MDR) bacteria confirms that nursing home residency is not a risk factor for MDR pneumonia in Germany. For individual risk assessment in this susceptible population, immobility and malnutrition should be considered as signs of functional impairment as well as comorbidity.

Indexed as

Nursing HomesAgedAged, 80 and overCarrier StateCross-Sectional StudiesEscherichia coliFemaleGermanyHumansLogistic ModelsMaleMultimorbidityNoseOropharynxPrevalenceProspective Studies

Identifiers

PMID29304069
PMCPMC5755901
OpenAlexW2782413595

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.