scholarly journals Prevalence of Ceftriaxone-and Ceftazidime-Resistant Gram-Negative Bacteria in Long-Term–Care Facilities

2001 ◽  
Vol 22 (4) ◽  
pp. 193-194 ◽  
Author(s):  
Lona Mody ◽  
Suzanne F. Bradley ◽  
Larry J. Strausbaugh ◽  
Robert R. Muder
2018 ◽  
Vol 46 (1) ◽  
pp. 76-80 ◽  
Author(s):  
Eva Leitner ◽  
Elisabeth Zechner ◽  
Elisabeth Ullrich ◽  
Gernot Zarfel ◽  
Josefa Luxner ◽  
...  

2014 ◽  
Vol 35 (5) ◽  
pp. 519-526 ◽  
Author(s):  
Indumathi Venkatachalam ◽  
Hsu Li Yang ◽  
Dale Fisher ◽  
David C. Lye ◽  
Ling Moi Lin ◽  
...  

Objective.Prevalence of multidrug-resistant (MDR) gram-negative (GN) bacteria is increasing globally and is complicated by patient movement between acute and long-term care facilities (LTCFs). In Asia, the contribution of LTCFs as a source of MDR GN infections is poorly described. We aimed to define the association between residence in LTCFs and MDR GN bloodstream infections (BSIs).Design.Secondary analysis of data from an observational cohort.Setting.Two tertiary referral hospitals in Singapore, including the 1,400-bed Tan Tock Seng Hospital and the 1,600-bed Singapore General Hospital.Participants.Adult patients with healthcare-onset (HCO) or hospital-onset (HO) GN BSI.Methods.Patients were identified from hospital databases using standard definitions. Risk factors for both MDR GN HCO and HO BSI were analyzed using a multivariable logistic regression model.Results.A total of 675 episodes of GN BSI occurred over a 31-month period. Residence in a LTCF was an independent risk factor for developing MDR GN BSI (odds ratio [OR], 5.1 [95% confidence interval (CI), 2.2–11.9]; P < .01) when antibiotics were not used within the preceding 30 days. This risk persisted beyond the first 48 hours of hospitalization (OR, 3.4 [95% CI, 1.3–9.0]; P = .01). Previous culture growing an MDR organism (OR, 1.8 [95% CI, 1.3–2.7]; P < .01), previous antibiotic use (OR, 1.8 [95% CI, 1.2–2.6]; P < .01), and intensive care unit stay (OR, 2.2 [95% CI, 1.2–3.9]; P = .01), increased the risk of MDR GN BSI.Conclusions.Residence in a LTCF is an independent risk factor for MDR GN BSI. Attempts to contain MDR GN bacteria in large Asian cities, where the proportion of the population that is elderly is projected to increase, should include infection prevention strategies that engage LTCFs.


2010 ◽  
Vol 31 (11) ◽  
pp. 1148-1153 ◽  
Author(s):  
Erin O'Fallon ◽  
Ruth Kandell ◽  
Robert Schreiber ◽  
Erika M. C. D'Agata

Background and Objective.An improved understanding of the transmission dynamics of multidrug-resistant (MDR) gram-negative bacteria and the mechanism of acquisition in long-term care facilities (LTCFs) could aid in the development of prevention strategies specific to LTCFs. We thus investigated the incidence of acquisition of these pathogens among an LTCF population.Design.Prospective cohort study.Setting.Three separate wards at a 600-bed LTCF in metropolitan Boston, Massachusetts, during the period October 31, 2006, through October 22, 2007.Participants.One hundred seventy-two LTCF residents.Methods.A series of rectal samples were cultured to determine acquisition of MDR gram-negative bacteria, defined as absence of MDR gram-negative bacterial colonization at baseline and de novo recovery of MDR gram-negative bacteria from a follow-up culture. Molecular typing was performed to identify genetically linked strains. A nested matched case-control study was performed to identify risk factors associated with acquisition.Results.Among 135 residents for whom at least 1 follow-up culture was performed, 52 (39%) acquired at least 1 MDR gram-negative organism during the study period. Thirty-two residents (62%) had not been colonized at baseline and had acquired at least 1 MDR gram-negative species at follow-up culture, and 20 residents (38%) were colonized at baseline and had acquired at least I MDR gram-negative species at follow-up culture. The most common coresistance pattern was resistance to extended-spectrum penicillins, ciprofloxacin, and gentamicin (57 isolates [42.5%]). Genetically related strains of MDR gram-negative bacteria were identified among multiple residents and between roommates. On conditional logistic regression analysis, antibiotic exposure during the study period was significantly associated with acquisition of MDR gram-negative bacteria (odds ratio, 5.6 [95% confidence interval, 1.1-28.7];P= .04).Conclusions.Acquisition of MDR gram-negative bacteria occurred frequently through resident-to-resident transmission. Existing infection control interventions need to be reevaluated.


2008 ◽  
Vol 56 (7) ◽  
pp. 1276-1280 ◽  
Author(s):  
Aurora Pop-Vicas ◽  
Susan L. Mitchell ◽  
Ruth Kandel ◽  
Robert Schreiber ◽  
Erika M. C. D'Agata

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