Exploring antimicrobial resistance in long-term care facilities for people with intellectual disabilities: results from a national surveillance study in the Netherlands
1
Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
2
Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Antimicrobial resistance (AMR) is a growing public health challenge worldwide, and may especially affect the health of vulnerable groups. People with intellectual disabilities (ID) often need lifelong support due to multimorbidity and frailty at a young age(1). Preventing infections with resistant microorganisms is crucial to safeguarding their health and wellbeing. However, until now, the prevalence of AMR among individuals with ID remains largely understudied.
METHODS:
We analyzed data from the Dutch national AMR surveillance system (ISIS-AR), which collects bacterial susceptibility data generated during routine diagnostics from clinical microbiology laboratories nationwide(2). Infection-related isolates were included from cultures ordered by intellectual disability physicians, sampled between 2018 and 2024. Resistance was determined using phenotypical/genotypical testing results for six resistant micro-organisms from the WHO Bacterial priority list: Extended-spectrum beta-lactamase- and carbapenemase-producing Enterobacterales (ESBL-E, CPE), carbapenemase-producing Acinetobacter spp. (CPA) and Pseudomonas aeruginosa (CPPA), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococci (VRE)(3).
RESULTS:
We included 3372 isolates from 1654 individuals with ID, with 48% of the isolates originating from older adults and urine being the most frequent specimen type (85%). ESBL-E prevalence was 3.2% (95% CI: 2.5%–4.0%). The prevalence of CPPA and MRSA was low (1.3% and 0.04%, respectively), and no cases of CPE, CPA, or VRE were detected.
CONCLUSIONS:
In this sample, overall prevalence of AMR among people with ID in long-term care was considered low and comparable to findings from general patient and nursing home population in the Netherlands(4). However, the proportion of ESBL positive isolates was highest in the oldest age group (>75 years: 8.7%), versus 1–4% in younger groups, indicating increased ESBL prevalence in older people with ID. Larger studies are needed to more accurately determine the AMR burden among people with ID and to identify risk-groups for which more targeted AMR surveillance and infection prevention strategies may be needed.
Antimicrobial resistance (AMR) is a growing public health challenge worldwide, and may especially affect the health of vulnerable groups. People with intellectual disabilities (ID) often need lifelong support due to multimorbidity and frailty at a young age(1). Preventing infections with resistant microorganisms is crucial to safeguarding their health and wellbeing. However, until now, the prevalence of AMR among individuals with ID remains largely understudied.
METHODS:
We analyzed data from the Dutch national AMR surveillance system (ISIS-AR), which collects bacterial susceptibility data generated during routine diagnostics from clinical microbiology laboratories nationwide(2). Infection-related isolates were included from cultures ordered by intellectual disability physicians, sampled between 2018 and 2024. Resistance was determined using phenotypical/genotypical testing results for six resistant micro-organisms from the WHO Bacterial priority list: Extended-spectrum beta-lactamase- and carbapenemase-producing Enterobacterales (ESBL-E, CPE), carbapenemase-producing Acinetobacter spp. (CPA) and Pseudomonas aeruginosa (CPPA), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococci (VRE)(3).
RESULTS:
We included 3372 isolates from 1654 individuals with ID, with 48% of the isolates originating from older adults and urine being the most frequent specimen type (85%). ESBL-E prevalence was 3.2% (95% CI: 2.5%–4.0%). The prevalence of CPPA and MRSA was low (1.3% and 0.04%, respectively), and no cases of CPE, CPA, or VRE were detected.
CONCLUSIONS:
In this sample, overall prevalence of AMR among people with ID in long-term care was considered low and comparable to findings from general patient and nursing home population in the Netherlands(4). However, the proportion of ESBL positive isolates was highest in the oldest age group (>75 years: 8.7%), versus 1–4% in younger groups, indicating increased ESBL prevalence in older people with ID. Larger studies are needed to more accurately determine the AMR burden among people with ID and to identify risk-groups for which more targeted AMR surveillance and infection prevention strategies may be needed.
| eISSN: | 2654-1459 |
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