Antimicrobial Susceptibility of Respiratory Isolates from Homeless Population in an Urban Environment

Abstract

Resistance to ATB from respiratory isolates of homeless residents with symptoms of URTI in 2012 - 2017 were analyzed. Resistance was tested in years 2008, 2012 and 2016 with no major resistance patterns found. MRSA resistance was less than 5% and PR less than 3% of all isolates. Despite majority of increasing population is not vaccinated against H. influenza and St. pneumonia, influenza, no major ID outbreaks were present and no case of TB was noted.

Headnote

Key words:

ATB resistance, Respiratory infections, Homeless population.

Abstract:

Resistance to ATB from respiratory isolates of homeless residents with symptoms of URTI in 2012 - 2017 were analyzed. Resistance was tested in years 2008, 2012 and 2016 with no major resistance patterns found. MRSA resistance was less than 5% and PR less than 3% of all isolates. Despite majority of increasing population is not vaccinated against H. influenza and St. pneumonia, influenza, no major ID outbreaks were present and no case of TB was noted.

Conflict of interests:

The authors whose names are listed in the title of the article certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, or other equity interest), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Introduction

The number of homeless population in the EU is increasing. The homeless population may be at risk of certain communicable diseases such as tuberculosis, hepatitis B, C, HIV, pediculosis, scabies and other skin and soft tissue infections. Some areas with high appearance of homeless people experienced epidemics of MRSA and other outbreaks. (1-5) The aim of this communication was to describe common ID in two outpatient health care facilities for homeless in 20122017 in Bratislava; screening for about half a million permanent citizens of capitol and 100,000 migrating population on a daily basis from surrounding cities.

Patients and Methods

From December 2012 to January 2017, we have recorded more than 6,000 visits of homeless between the ages 19 to 86. Ambulatory treatment was offered for the majority of cases after assessment of their health status, either in the St. Elisabeth University shelter, or Mea Culpa Dormitory shelters in Bratislava.

Results

3,131 homeless patients (50.1%) presented with infectious diseases; commonest were upper respiratory tract infections (70.5%) followed by skin and soft tissue infections (20.5%) and ecto-parasites (5.1%, scabies as commonest). Only about 4.7% of all cases with severe ID were diagnosed; commonest diagnoses being pneumonia, infected necrosis of lower limbs after frostbites or leg ulcers. Only four suspected but not confirmed cases of TB have been described (0.1%) which is in correlation with the average Slovak population with 0.01-0.1% prevalence (Tab.1). Concerning antimicrobials used amoxycilin, azitromycine, doxycycline and cotrimoxazole for SSTI and scabicides for ectoparasites with or without ivermectin has been commonly used. In 103 symptomatic homeless patients with lower RTI, swabs from nose and tonsils were obtained but no emergence of resistance in respiratory pathogens has been observed. Only one isolate of Penicillin resistant Pneumococcus (PRP) (1%) and three MRSA (3.95%) have been observed.

Conclusion

According to our 15 years epidemiological observation, homeless population does not represent major threat for other urban population in Bratislava. To decrease the incidence of upper RTI in homeless patients, vaccination against influenza a pneumococci mainly in patients over 65 years old should be considered and also for those staying in stationary shelters. Regular swabs from respiratory and gastrointestinal tract are advisable too.

Sidebar

E-mail address:

[email protected]

Reprint address:

Michael Olah

i-GAP Vienna International Society of Applied Preventive Medicine Erdbergstrasse 33 1090 Vienna, AT

Suource: Clinical Social Work and Health Intervention Volume: 8 Issue: 1

Pages: 11 - 14 Cited references: 13

Reviewers:

Dr. Gabriela Lezcano, Ph.D.

University of California San Francisco, USA

Dr. Katerina Mullera

MPC Center Eldoret, KE

Publisher:

International Society of Applied Preventive Medicine i-gap

References

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