Antimicrobial resistance in long-term-care facilities

Larry J. Strausbaugh, Kent B. Crossley, Brenda A. Nurse, Lauri D. Thrupp, David W. Bentley, Richard A. Garibaldi, Ellen G. Neuhaus, Lindsay E. Nicolle, Philip W. Smith

Research output: Contribution to journalArticle

151 Citations (Scopus)

Abstract

During the last quarter century, numerous reports have indicated that antimicrobial resistance commonly is encountered in long-term-care facilities (LTCFs). Gramnegative uropathogens resistant to penicillin, cephalosporin, aminoglycoside, or fluoroquinolone antibiotics and methicillin-resistant Staphylococcus aureus have received the greatest attention, but other reports have described the occurrence of multiply-resistant strains of Haemophilus influenzae and vancomycin-resistant enterococci (VRE) in this setting. Antimicrobial-resistant bacteria may enter LTCFs with colonized patients transferred from the hospital, or they may arise in the facility as a result of mutation or gene transfer. Once present, resistant strains tend to persist and become endemic. Rapid dissemination also has been documented in some facilities. Person-to-person transmission via the hands of healthcare workers appears to be the most important means of spread. The LTCF patients most commonly affected are those with serious underlying disease, poor functional status, wounds such as pressure sores, invasive devices such as urinary catheters, and prior antimicrobial therapy. The presence of antimicrobial-resistant pathogens in LTCFs has serious consequences not only for residents but also for LTCFs and hospitals. Experience with control strategies for antimicrobial-resistant pathogens in LTCFs is limited; however, strategies used in hospitals often are inapplicable. Six recommendations for controlling antimicrobial resistance in LTCFs are offered, and four priorities for future research are identified.

Original languageEnglish (US)
Pages (from-to)129-140
Number of pages12
JournalInfection Control and Hospital Epidemiology
Volume17
Issue number2
DOIs
StatePublished - Feb 1996

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Long-Term Care
Urinary Catheters
Pressure Ulcer
Fluoroquinolones
Haemophilus influenzae
Aminoglycosides
Cephalosporins
Methicillin-Resistant Staphylococcus aureus
Penicillins
Hand
Anti-Bacterial Agents
Bacteria
Delivery of Health Care
Equipment and Supplies
Mutation
Wounds and Injuries
Genes

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Strausbaugh, L. J., Crossley, K. B., Nurse, B. A., Thrupp, L. D., Bentley, D. W., Garibaldi, R. A., ... Smith, P. W. (1996). Antimicrobial resistance in long-term-care facilities. Infection Control and Hospital Epidemiology, 17(2), 129-140. https://doi.org/10.2307/30141013

Antimicrobial resistance in long-term-care facilities. / Strausbaugh, Larry J.; Crossley, Kent B.; Nurse, Brenda A.; Thrupp, Lauri D.; Bentley, David W.; Garibaldi, Richard A.; Neuhaus, Ellen G.; Nicolle, Lindsay E.; Smith, Philip W.

In: Infection Control and Hospital Epidemiology, Vol. 17, No. 2, 02.1996, p. 129-140.

Research output: Contribution to journalArticle

Strausbaugh, LJ, Crossley, KB, Nurse, BA, Thrupp, LD, Bentley, DW, Garibaldi, RA, Neuhaus, EG, Nicolle, LE & Smith, PW 1996, 'Antimicrobial resistance in long-term-care facilities', Infection Control and Hospital Epidemiology, vol. 17, no. 2, pp. 129-140. https://doi.org/10.2307/30141013
Strausbaugh LJ, Crossley KB, Nurse BA, Thrupp LD, Bentley DW, Garibaldi RA et al. Antimicrobial resistance in long-term-care facilities. Infection Control and Hospital Epidemiology. 1996 Feb;17(2):129-140. https://doi.org/10.2307/30141013
Strausbaugh, Larry J. ; Crossley, Kent B. ; Nurse, Brenda A. ; Thrupp, Lauri D. ; Bentley, David W. ; Garibaldi, Richard A. ; Neuhaus, Ellen G. ; Nicolle, Lindsay E. ; Smith, Philip W. / Antimicrobial resistance in long-term-care facilities. In: Infection Control and Hospital Epidemiology. 1996 ; Vol. 17, No. 2. pp. 129-140.
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