Antibiotic resistance is prevalent and varied in long-term-care facilities
Research Activities, January 2010, No. 353
Patients in long-term-care facilities are often frail and suffer from a variety of health problems. They are at increased risk for infection from various bacteria, which can often be resistant to antibiotics. In fact, a new study found a marked prevalence of resistance to multiple antibiotics among a number of bacterial organisms present in long-term-care residents.
Researchers at the Center for Education and Research on Therapeutics (CERT) at the University of Pennsylvania School of Medicine studied 63 long-term- care facilities in New Jersey, Pennsylvania, and Delaware. They reviewed all clinical urine samples obtained from residents during a 10-month period. They reviewed antibiotic susceptibility data for all organisms isolated.
The three organisms most commonly isolated in the urine samples were Escherichia coli, Klebsiella species, and Proteus mirabilis. A little over half (51 percent) of the E. coli isolates and 29 percent of Klebsiella species were found to be resistant to levofloxacin, a member of the fluoroquinolone class of antibiotics frequently used to treat infections. Just over a quarter (26 percent) of Klebsiella species and 12 percent of E. coli isolates were resistant to ceftazidime. Six percent of Klebsiella species were resistant to imipenem.
The researchers also found differences in antibiotic resistance rates across the long-term-care facilities. Resistance rates for several antibiotics were lowest for facilities with fewer than 100 beds. Higher rates of resistance were found in facilities with 100 to 150 beds. Different patterns of resistance were also noted for various geographic regions where these long-term-care facilities resided.
The study was supported in part by a grant from the Agency for Healthcare Research and Quality (HS10399) to the University of Pennsylvania School of Medicine CERT. For more information on the CERTs program, visit the Centers for Education & Research on Therapeutics (CERTs) Web site.
See "Epidemiology of antimicrobial resistance among gram-negative organisms recovered from patients in a multistate network of long-term care facilities," by Ebbing Lautenbach, M.D., M.P.H., M.S.C.E., Roseann Marsicano, B.S., Pam Tolomeo, M.P.H., and others in the August 2009 Infection Control and Hospital Epidemiology 30(8), pp. 790-793.