Rosello Gilchrist, A;
Hayward, AC;
Hopkins, S;
Horner, C;
Ironmonger, D;
Hawkey, PM;
Deeny, SR;
(2017)
Impact of long-term care facility residence on the antibiotic resistance of urinary tract E. coli and Klebsiella.
Journal of Antimicrobial Chemotherapy
, 72
(4)
pp. 1184-1192.
10.1093/jac/dkw555.
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Abstract
BACKGROUND: Long-term care facilities (LTCFs) are thought to be important reservoirs of antimicrobial-resistant (AMR) bacteria; however, there is no routine surveillance of resistance in LTCF residents, or large population-based studies comparing AMR in LTCFs with the community, so the relative burden of AMR in LTCFs remains unknown. OBJECTIVES: To compare the frequency of antibiotic resistance of urinary tract bacteria from residents of LTCFs for the elderly and adults aged 70 years or older living in the community. METHODS: Positive urine specimens reported to any diagnostic microbiology laboratory in the West Midlands region (England) from 1 April 2010 to 31 March 2014 collected from individuals aged 70 years or older were analysed. The resistance of Escherichia coli and Klebsiella to trimethoprim, nitrofurantoin, third-generation cephalosporins and ciprofloxacin and the rate of laboratory-confirmed E. coli and Klebsiella urinary tract infection (UTI) were assessed in LTCF residents and in the community. RESULTS: LTCF residents had a laboratory-confirmed E. coli and Klebsiella UTI rate of 21 per 100 person years compared with 8 per 100 person years in the elderly living in the community [rate ratio (RR)=2.66, 95% CI = 2.58–2.73] and a higher rate of developing E. coli and Klebsiella UTIs caused by bacteria resistant to trimethoprim (RR = 4.41, 95% CI = 4.25–4.57), nitrofurantoin (RR = 4.38, 95% CI = 3.98–4.83), ciprofloxacin (RR = 5.18, 95% CI = 4.82–5.57) and third-generation cephalosporins (RR = 4.49, 95% CI = 4.08–4.94). CONCLUSIONS: Residents of LTCFs for the elderly had more than double the rate of E. coli and Klebsiella UTI and more than four times the rate of E. coli and Klebsiella UTI caused by antibiotic-resistant bacteria compared with those living in the community.
| Type: | Article |
|---|---|
| Title: | Impact of long-term care facility residence on the antibiotic resistance of urinary tract E. coli and Klebsiella |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/jac/dkw555 |
| Publisher version: | http://dx.doi.org/10.1093/jac/dkw555 |
| Language: | English |
| Additional information: | TThis version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | antibiotic resistance, bacterial, ciprofloxacin, urinary tract infection, adult, internship and residency, klebsiella, long-term care, nitrofurantoin, trimethoprim, urinary tract, bacteria, diagnosis, microbiology, escherichia coli, elderly, surveillance, medical, medical residencies, community, urine specimens |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1535323 |
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