Skip to main content Accessibility help

Epidemiology of Antimicrobial Resistance among Gram-Negative Organisms Recovered from Patients in a Multistate Network of Long-Term Care Facilities

  • Ebbing Lautenbach (a1) (a2) (a3) (a4), Roseann Marsicano (a5), Pam Tolomeo (a3), Michael Heard (a5), Steve Serrano (a5) and Donald D. Stieritz (a5)...


We identified 1,805 gram-negative organisms in cultures of urine samples obtained over a 10-month period from residents of 63 long-term care facilities. The prevalence of fluoroquinolone resistance in Escherichia coli was 51% (446 of 874 isolates), whereas the preva¬lences of ceftazidime and imipenem resistance in Klebsiella species were 26% and 6% (84 and 19 of 323 isolates), respectively. The prevalence of resistance varied significantly by facility type, size, and geographic location.


Corresponding author

University of Pennsylvania School of Medicine, Center for Clinical Epidemiology and Biostatistics, 825 Blockley Hall, 423 Guardian Dr, Philadelphia, PA 19104-6021 (


Hide All
1.Smith, PW, Bennett, G, Bradley, S, et al.SHEA/APIC guideline: infection prevention and control in the long-term care facility. Infect Control Hosp Epidemiol 2008;29:785814.
2.Viray, M, Linkin, D, Maslow, JN, et al.Longitudinal trends in antimicrobial susceptibilities across long term care facilities: emergence of fluoroquinolone resistance. Infect Control Hosp Epidemiol 2005;26:5662.
3.Strausbaugh, LJ, Crossley, KB, Nurse, BA, Thrupp, LD. Antimicrobial resistance in long-term care facilities. Infect Control Hosp Epidemiol 1996;17:129140.
4.Smith, PW, Rusnak, PG. Infection prevention and control in the long-term-care facility: SHEA Long-Term-Care Committee and APIC Guidelines Committee. Infect Control Hosp Epidemiol 1997;18:831849.
5.Yoshikawa, TT. Antimicrobial resistance and aging: beginning of the end of the antibiotic era? J Am Geriatr Soc 2002;50(suppl):S226229.
6.Nicolle, LE, Strausbaugh, LJ, Garibaldi, RA. Infections and antibiotic resistance in nursing homes. Clin Microbiol Rev 1996;9:117.
7. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing: 18th informational supplement. Wayne, PA: CLSI, 2008:M100-S18.
8.Kleinbaum, DG, Kupper, LL, Morgenstern, H. Epidemiologie research:principles and quantitative methods. New York: Van Nostrand Reinhold; 1982.
9.Lipworth, AD, Hyle, EP, Fishman, NO, et al.Limiting the emergence of extended-spectrum β-lactamase-producing Enterobacteriaceae: influence of patient population characteristics on the response to antimicrobial formulary interventions. Infect Control Hosp Epidemiol 2006;27:27986.
10.Urban, C, Bradford, PA, Tuckman, M, et al.Carbapenem-resistant Escherichia coli harboring Klebsiella pneumoniae carbapenemase β-lactamases associated with long-term care facilities. Clin Infect Dis 2008;46:e127130.


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed