Results. We surveyed 24 of 25 eligible short-stay acute care hospitals and 7 of 7 eligible LTACHs. Among LTACHs, 30.4% (119 of 391) of patients were colonized with KPC-producing Enterobacteriaceae, compared to 3.3% (30 of 910) of short-stay hospital ICU patients (prevalence ratio, 9.2; 95% confidence interval, 6.3–13.5). All surveyed LTACHs had patients harboring KPC (prevalence range, 10%–54%), versus 15 of 24 short-stay hospitals (prevalence range, 0%–29%). Several patient-level covariates present at the time of survey—LTACH facility type, mechanical ventilation, and length of stay—were independent risk factors for KPC-producing Enterobacteriaceae colonization.
Conclusions. We identified high colonization prevalence of KPC-producing Enterobacteriaceae among patients in LTACHs. Patients with chronic medical care needs in long-term care facilities may play an important role in the spread of these extremely drug-resistant pathogens.
That's astounding. Take home lesson? You might want to check the antibiograms of the LTACs in your area to guide initial antibiotic therapy should a recent LTAC patient present septic to your hospital.