{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:42:24Z","timestamp":1792154544912,"version":"4.4.0"},"reference-count":36,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T00:00:00Z","timestamp":1648598400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X22000575_as1\"><jats:title>Objective:<\/jats:title><jats:p>To characterize the epidemiology of methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA), vancomycin-resistant enterococci (VRE), and carbapenemase-producing Enterobacterales (CPE) co-colonization and to compare risk factors between healthcare facility types.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22000575_as2\"><jats:title>Design, setting, and participants:<\/jats:title><jats:p>We conducted a 3-year cross-sectional study among patients admitted to an acute-care hospital (ACH) and its 6 closely affiliated intermediate- and long-term care facilities (ILTCFs) in Singapore in June and July of 2014\u20132016.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22000575_as3\"><jats:title>Methods:<\/jats:title><jats:p>Specimens were concurrently collected from nares, axillae, and groins for MRSA detection, and from rectum or stool for VRE and CPE detection. Co-colonization was defined as having &gt;1 positive culture of MRSA\/VRE\/CPE. Multinomial logistic regression was performed to determine predictors of co-colonization.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22000575_as4\"><jats:title>Results:<\/jats:title><jats:p>Of 5,456 patients recruited, 176 (3.2%) were co-colonized, with higher prevalence among patients in ITCFs (53 of 1,255, 4.2%) and the ACH (120 of 3,044, 3.9%) than LTCFs (3 of 1,157, 0.3%). MRSA\/VRE was the most common type of co-colonization (162 of 5,456, 3.0%). Independent risk factors for co-colonization included male sex (odds ratio [OR], 1.96; 95% confidence interval [CI], 1.37\u20132.80), prior antibiotic therapy of 1\u20133 days (OR, 10.39; 95% CI, 2.08\u201351.96), 4\u20137 days (OR, 4.89; 95% CI, 1.01\u201323.68), &gt;7 days (OR, 11.72; 95% CI, 2.81\u201348.85), and having an open wound (OR, 2.34; 95% CI, 1.66\u20133.29). Additionally, we detected the synergistic interaction of length of stay &gt;14 days and prior multidrug-resistant organism (MDRO) carriage on co-colonization. Having an emergency surgery was a significant predictor of co-colonization in ACH patients, and we detected a dose\u2013response association between duration of antibiotic therapy and co-colonization in ILTCF patients.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22000575_as5\"><jats:title>Conclusions:<\/jats:title><jats:p>We observed common and differential risk factors for MDRO co-colonization across healthcare settings. This study has identified at-risk groups that merit intensive interventions, particularly patients with prior MDRO carriage and longer length of stay.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2022.57","type":"journal-article","created":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T08:06:13Z","timestamp":1648627573000},"page":"31-39","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":7,"title":["Synergistic effects of length of stay and prior MDRO carriage on the colonization and co-colonization of methicillin-resistant <i>Staphylococcus aureus<\/i>, vancomycin-resistant <i>Enterococcus<\/i>, and carbapenemase-producing Enterobacterales across healthcare settings"],"prefix":"10.1017","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2307-0610","authenticated-orcid":false,"given":"Htet 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