Carriage of multi-drug-resistant microorganisms amongst patients admitted to a palliative care ward in Poland.

Aim
To understand the extent of multidrug-resistant organism (MDRO) presence amongst all patients admitted to a Palliative and Hospice Care Department (PHCD). Subsequent to this, determine the possibilities for optimizing healthcare particularly regarding necessary scope and frequency of conducting microbiological screening tests (MST) among PHCD patients.

Material and methods
The research was conducted using a retrospective method during the patient's stay at the hospital ward. The study involved 799 patients (382 men and 417 women, average age: 73.5 years) hospitalized at the PHCD. All patients were admitted to the PHCD by MST to detect MDRO; for this purpose a swab from the nasal vestibule and anus was taken. A comparative analysis was conducted concerning diseases qualifying patients for admission to PHCD with 29 assumed risk factors for hospital acquired infections (RFHAI) and results of the MSTs.

Results
Among the 799 tested patients, alarm pathogens (AP) were detected in 299 (37.4%) and in 500 patients (62.6%) APs were not found. Among 299 PHCD patients carrying APs, 255 (85.3%) were confirmed with colonization and 44 (14.7%) had HAI. A statistically significant relationship was found between disease qualifying for PHCD admission and the occurrence of Enterococcus VRE bacteria (p-value = 0.05776), ESBL-producing Citrobacter (P-value = 0.01352), and ESBL-producing Proteus mirabilis (P-value = 0.00793).

Conclusions
MSTs performed on patients admitted to the hospital ward showed a high percentage (37.4%) of APs and frequent occurrence of HAI. This confirms the desirability of continuing MST in PHCD patients.