Preventing Superbugs in Aged Care Facilities

Researchers from Flinders University and SAHMRI caution that in order to safeguard elderly residents of residential aged care facilities against the potentially fatal spread of antibiotic-resistant bacteria, or “superbugs,” there is an urgent need for more cautious antibiotic management.

The widespread use of antibiotics in residential aged care and the subsequent development of antibiotic-resistant bacteria in the gut that can be transferred to other residents are the subjects of a recent study that was published in the reputable Journal of Infection.

“Commonly used tablet antibiotics in the elderly increase many types of resistance bacteria carried in the gut and these so-called ‘superbugs’ can increase resistance to other important life-saving antibiotic drugs.”- Sophie Miller, Study Lead Author and PhD Student, Flinders University

Miller added, “High rates of antibiotic prescriptions in aged care settings are likely to be contributing to the proliferation of these bugs, which can lead to longer hospital stays, higher medical costs, and increased mortality.

“This trend not only compromises the effectiveness of antibiotic treatment but also poses a significant risk of treatment failures in an already vulnerable community.”

Antibiotic resistance is a major threat to global health, food security, and development, according to the World Health Organization. A growing number of infections, such as salmonellosis, gonorrhea, pneumonia, and tuberculosis, are becoming more difficult to treat as the antibiotics used to treat them become less effective.

“Responding effectively to the global health threat of antibiotic resistance requires a detailed understanding of the influence and impact of antibiotic prescribing patterns,” Sophie Miller states.

To find out more about the genes carried by the gut bacteria of 164 inhabitants of five long-term elderly care institutions in South Australia that cause antibiotic resistance, the researchers examined stool samples from the people.

“We discovered that an antibiotic commonly prescribed to aged care residents was strongly associated with an increase in resistance to other antibiotics the resident had not been prescribed,” she explains.

Worryingly, studies found that almost all subjects contained these resistance genes in the absence of any symptoms, which raises serious questions for this especially vulnerable group.

“Our findings suggest that even antibiotics that are not typically associated with major modifications in gut bacteria can significantly escalate the presence of resistance genes,” Miller states.

The implications of this study go beyond individual patient treatment, according to senior author Professor Geraint Rogers, Director of the Microbiome and Host Health Program at SAHMRI and Matthew Flinders Fellow in the College of Medicine and Public Health at Flinders University.

“As the population ages and life expectancy extends, the implications of our findings emphasize the importance of a holistic approach to antibiotic management in long-term aged care settings,” Professor Rogers states.

“There are concerns that practitioners may be overprescribing antibiotics, potentially increasing the risk of resistant bacterial infections, and this study’s findings suggest a need for extra caution when prescribing them for older patients.”

For more information: Exposure to doxycycline increases risk of carrying a broad range of enteric antimicrobial resistance determinants in an elderly cohort,  Journal of Infection, https://doi.org/10.1016/j.jinf.2024.106243