Résumé
Background: multi-drug resistant (MDR) enterobacteria (such as Extended-spectrum beta-Lactamase producing enterobacteria (ESBL-PE)), carbapenemase-producing enterobacteria (CPE), vancomycin resistant enterococci (VRE), and toxigenic Clostridioides difficile (tCD), are among the major threats to human health identified by the world health organization (WHO). In the elderly care centers (ECC), the prevalence of these micro-organisms is unknown.Objectives: we conducted a worldwide Systematic Review on the prevalence and risk factors of MDR bacteria, including ESBL-PE or multidrug-resistant acinetobacter baumannii (MDRAB), carbapenemase-producing Enterobacteria (CPE), VRE and CD in ECCs.Methods: we searched PubMed, Web of Science and Cochrane databases for all studies published on the prevalence of MDR digestive bacteria, CPE, VRE and CD.Results: among the prevalence studies in ECCs throughout the world that had reported the prevalence of MDR enterobacteria, CPE, VRE or tCD, global prevalence estimated is 13.8%, 1.3%, 0.1% and 16.5% respectively. The risk factors for carriage identified are: incontinence, presence of invasive medical device and prior use of antibiotics.Conclusion: colonization with ESBL-PE or tCD is common in this population, with nearly one in six residents being colonized. We can consider that CPE and VRE colonization rates remain low in ECCs. The risk factors for colonization identified align with findings in the literature. To limit the spread ofmulti-resistant bacteria, EPC, VRE and tCD in ECCs, appropriate antibiotics stewardship and adherence to infection control measures appear essential.