GRACE Study Stage 2 Report

23 Nov 2021: Stage 2 of the GRACE study, descriptive analysis, has now been completed.

The Generating evidence on Resistant bacteria in the Aged Care Environment (GRACE) study aimed to address five questions that are fundamental to developing strategies to reduce AMR carriage in RACF residents:

1) What factors determine the types and levels of AMR carried by RACF residents?
2) To what extent is there evidence of AMR transmission between RACF residents?
3) Is interaction with the RACF built environment likely to facilitate AMR transmission?
4) Do hospital visits for acute care significantly influence types and levels of AMR carriage?
5) To what extent do ageing-associated changes in gut microbiology influence AMR carriage?

GRACE was a cross-sectional study supported by a Medical Research Future Fund grant involving five aged care facilities in metropolitan Adelaide, Australia. Participants were invited to provide stool and oropharyngeal samples for metagenomic analysis to determine microbiome and resistome characteristics. Environmental samples were collected from sites within each facility to determine the role of the environment in AMR transmission. The study also accessed Pharmaceutical Benefits Scheme and Medicare Benefits Schedule data for consenting participants. Data on clinical care, facility management practices, including cleaning, provision of care, and staffing, were obtained directly from RACF providers.  

This report provides an overview of participant demographics, health status and comorbidities, medication and health system utilisation, facility characteristics, and a preliminary analysis of faecal and oropharyngeal microbiota composition and resistome. Analysis of environmental samples collected from participating sites is not included. Study data are presented prior to integrative analysis to address the five study aims.

Read the report below.