{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T13:27:44Z","timestamp":1774618064322,"version":"3.50.1"},"reference-count":40,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T00:00:00Z","timestamp":1662508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Extended-spectrum-\u03b2-lactamase (ESBL)- and carbapenemase-producing bacteria are widespread in hospitals, but the extent of this problem in long-term care facilities (LTCFs) is poorly understood. We aimed to elucidate, in the Portuguese regional clinical context, the relevance of LTCFs as a reservoir of Escherichia coli and Klebsiella spp. producing ESBL- and\/or carbapenemases (Ec\/Kp-ESBL\/CARB). Fourteen LTCFs from Portugal, corresponding to units of convalescence (UC\/n = 3), medium-term internment and rehabilitation (UMDR\/ n = 5), or long-term internment and maintenance (ULDM\/n = 6), were analyzed (2016\u20132019). All patients with Ec\/Kp-ESBL\/CARB infections acquired during LTCF stay were included, and detailed information was collected. Prevalence of patients with healthcare-associated infections (HAIs) by Ec\/Kp-ESBL\/CARB did not vary significantly over time (1.48% in 2016\u20132017, 1.89% in 2017\u20132018, and 1.90% in 2018\u20132019), but a statistically significant association with the LTCF typology (ULDM, UMDR) was observed. HAIs were caused by K. pneumoniae (n = 51\/54.3%), E. coli (n = 41\/43.6%), or both (n = 2\/2.1%), producing ESBL (96%) or carbapenemases (4%). Prior colonization (n = 14\/16%) corresponded to seven Kp-CARB and seven Ec\/Kp-ESBL. The worrying prevalence of patients acquiring HAIs by Ec\/Kp-ESBL\/CARB, associated with the estimated rates of those already colonized at admission, highlights a relevant role for LTCFs as a reservoir of Ec\/Kp-ESBL\/CARB. Epidemiological surveillance should be extended to the national level, and colonization screening at LTCF admission implemented systematically.<\/jats:p>","DOI":"10.3390\/pathogens11091019","type":"journal-article","created":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T01:40:13Z","timestamp":1662601213000},"page":"1019","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Occurrence of Healthcare-Associated Infections (HAIs) by Escherichia coli and Klebsiella spp. Producing Extended-Spectrum \u03b2-lactamases (ESBL) and\/or Carbapenemases in Portuguese Long-Term Care Facilities"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2460-6504","authenticated-orcid":false,"given":"Elisabete","family":"Machado","sequence":"first","affiliation":[{"name":"Local Coordination Group of the Program for the Prevention and Control of Infections and Antimicrobial Resistance (GCL-PPCIRA), Service of Quality, Safety and Epidemiology, Hospital de Braga, 4710-243 Braga, Portugal"},{"name":"School of Medicine, University of Minho, 4710-057 Braga, Portugal"},{"name":"Biomedical Research Center\/UFP Energy, Environment and Health Research Unit (CEBIMED\/FP-ENAS), University Fernando Pessoa, 4200-150 Porto, Portugal"},{"name":"UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Microbiology, Department of Biological Sciences, REQUIMTE, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1201-9177","authenticated-orcid":false,"given":"Patr\u00edcio","family":"Costa","sequence":"additional","affiliation":[{"name":"Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal"},{"name":"ICVS\/3B\u2019s\u2014PT Government Associate Laboratory, 4710-057 Braga\/Guimar\u00e3es, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5683-3181","authenticated-orcid":false,"given":"Alexandre","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Local Coordination Group of the Program for the Prevention and Control of Infections and Antimicrobial Resistance (GCL-PPCIRA), Service of Quality, Safety and Epidemiology, Hospital de Braga, 4710-243 Braga, Portugal"},{"name":"Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal"},{"name":"ICVS\/3B\u2019s\u2014PT Government Associate Laboratory, 4710-057 Braga\/Guimar\u00e3es, Portugal"},{"name":"Service of Internal Medicine, Hospital de Braga, 4710-243 Braga, Portugal"}]},{"name":"on behalf of the SAREL Investigators","sequence":"additional","affiliation":[]}],"member":"1968","published-online":{"date-parts":[[2022,9,7]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (WHO) (2021). 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