Table 4.

Risk factors for colonization of Italian and other European LTCF residents with ESBL producing Enterobacteriaceae and/or MRSA

Risk factor	Bacterial resistance phenotype	References (Italy)	References (Other European countries)
High age	ESBL, MRSA	[13]	[8, 9, 60]
Male sex	ESBL, MRSA		[6, 9, 42, 46]
Physical disability, bedridden, low functional status	ESBL, MRSA	[13, 23]	[6, 8, 45–47, 49, 59–61]
Prolonged duration of stay in LTCF	MRSA	[23]
Invasive medical devices (urinary catheter, percutaneous enteral gastrostomy tube, tracheostomy tube)	ESBL, MRSA	[13, 20]	[7, 8, 42, 45, 46, 52, 59, 60]
Previous administration of antibiotics within the preceding year	ESBL, MRSA	[13, 20, 62]	[6, 7, 17, 47–49, 51, 52, 54, 58–61]
Colonization history by the same microorganism	ESBL, MRSA		[6, 7, 46, 49, 59, 61]
MDR bacteria carriage of other residents	MRSA		[46, 51]
Multiple room occupancy, MDR carrier in the same room	MRSA		[46]
Residency in specific unit within LTCF	ESBL, MRSA	[13, 14, 62]
Prior admission to acute care hospital	ESBL, MRSA	[20, 62]	[42, 45–47, 58, 60, 61]
Surgical procedures within 30 days	ESBL	[20]
Cancer	ESBL, MRSA	[13, 62]	[58]
Decubitus ulcer	ESBL, MRSA	[22]	[46, 48, 59, 60]
Various wounds, skin lesions	MRSA, ESBL		[6, 8, 45–47, 59]
Peptic ulcer, use of antiacids	ESBL, MRSA	[20]	[6]
Chronic renal failure	ESBL	[20]
History of urinary tract infections	ESBL		[17]
Urinary and faecal incontinency	ESBL, MRSA	[23]	[8, 58]
Chronic obstructive pulmonary disease (COPD)	ESBL, MRSA	[13, 20]
Diabetes	ESBL	[20]	[8]