Nursing home residents and Enterobacteriaceae resistant to third-generation cephalosporins

Limited data identify the risk factors for infection with Enterobacteriaceae resistant to third-generation cephalosporins among residents of long-term-care facilities. Using a nested case-control study design, nursing home residents with clinical isolates of Enterobacteriaceae resistant to third-gen...

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Bibliographic Details
Published in:Emerging infectious diseases 2004-06, Vol.10 (6), p.1050-1055
Main Authors: Sandoval, Carolyn, Walter, Stephen D, McGeer, Allison, Simor, Andrew E, Bradley, Suzanne F, Moss, Lorraine M, Loeb, Mark B
Format: Article
Language:English
Subjects:
Aged
Anti-Bacterial Agents - pharmacology
Canada
Case-Control Studies
Cephaloridine
Cephalosporin Resistance
Cephalosporins
Cephalosporins - pharmacology
Drug Resistance, Bacterial
Enterobacteriaceae
Enterobacteriaceae - drug effects
Enterobacteriaceae - growth & development
Enterobacteriaceae - isolation & purification
Enterobacteriaceae Infections
Enterobacteriaceae Infections - drug therapy
Enterobacteriaceae Infections - microbiology
Humans
Logistic Models
Long-Term Care
Microbial Sensitivity Tests
Moxalactam
Multivariate Analysis
Nursing Homes
Risk Factors
United States
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Summary:Limited data identify the risk factors for infection with Enterobacteriaceae resistant to third-generation cephalosporins among residents of long-term-care facilities. Using a nested case-control study design, nursing home residents with clinical isolates of Enterobacteriaceae resistant to third-generation cephalosporins were compared to residents with isolates of Enterobacteriaceae susceptible to third-generation cephalosporins. Data were collected on antimicrobial drug exposure 10 weeks before detection of the isolates, facility-level demographics, hygiene facilities, and staffing levels. Logistic regression models were built to adjust for confounding variables. Twenty-seven case-residents were identified and compared to 85 controls. Exposure to any cephalosporin (adjusted odds ratio [OR] 4.0, 95% confidence interval [CI] 1.2 to 13.6) and log percentage of residents using gastrostomy tubes within the nursing home (adjusted OR 3.9, 95% CI 1.3 to 12.0) were associated with having a clinical isolate resistant to third-generation cephalosporins.
ISSN:1080-6040
1080-6059
DOI:10.3201/eid1006.030662