AI Article Synopsis
- Antibiotic resistance (AR) in nursing homes is a significant issue, particularly concerning pathogens causing urinary tract infections (UTIs), prompting a study of reported data from 2013 to 2017.
- An analysis involving 243 nursing homes revealed that E. coli and Proteus spp. were the most common pathogens behind 5,485 UTI events, with notable resistance rates, particularly in E. coli, which showed 50% fluoroquinolone resistance and 20% resistance to extended-spectrum cephalosporins.
- The findings highlight that 36% of reported UTIs were due to resistant pathogens, underscoring the importance of understanding AR to enhance infection prevention and antibiotic management in nursing homes.
Article Abstract
Objective: Antibiotic resistance (AR) is a growing and highly prevalent problem in nursing homes. We describe selected AR phenotypes from pathogens causing urinary tract infections (UTIs) reported by nursing homes to the National Healthcare Safety Network (NHSN).
Design: Pathogens and antibiotic susceptibility testing results for UTI events in nursing homes between January 2013 and December 2017 were analyzed. The pathogen distribution and pooled mean proportion of isolates that tested resistant to select antibiotic agents are reported.
Setting And Participants: US nursing homes voluntarily participating in the Long-Term Care Facility component of the NHSN.
Results: Overall, 243 nursing homes reported 1 or more UTIs: 121 (50%) were nonprofit facilities, median bed size was 91 (range: 9-801), and average occupancy was 87%. In total, 6,157 pathogens were reported for 5,485 UTI events. Moreover, 9 pathogens accounted for 90% of all reported UTIs; the 3 most frequently identified were Escherichia coli (41%), Proteus species (14%), and Klebsiella pneumoniae/oxytoca (13%). Among E. coli, fluoroquinolone, and extended-spectrum cephalosporin resistance were most prevalent (50% and 20%, respectively). Although Staphylococcus aureus and Enterococcus faecium represented <5% of pathogens reported, they had the highest rates of resistance (67% methicillin resistant and 60% vancomycin resistant, respectively). Multidrug resistance was most common in Pseudomonas aeruginosa (11%). For the resistant phenotypes we assessed, 36% of all UTIs reported were associated with a resistant pathogen.
Conclusions: This is the first summary of AR among common pathogens causing UTIs reported to NHSN by nursing homes. Improved understanding of the resistance burden among common infections helps inform facility infection prevention and antibiotic stewardship efforts.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627066 | PMC |
| http://dx.doi.org/10.1017/ice.2020.348 | DOI Listing |
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