Antibiotic-resistant pathogens associated with urinary tract infections in nursing homes: Summary of data reported to the National Healthcare Safety Network Long-Term Care Facility Component, 2013–2017

2020 ◽  
Vol 42 (1) ◽  
pp. 31-36
Author(s):  
Taniece R. Eure ◽  
Nimalie D. Stone ◽  
Elisabeth A. Mungai ◽  
Jeneita M. Bell ◽  
Nicola D. Thompson
Keyword(s):  
Urinary Tract ◽  
Nursing Homes ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Long Term Care Facility ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Tract Infections

AbstractObjective: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.

scholarly journals The National Healthcare Safety Network Long-term Care Facility Component early reporting experience: January 2013-December 2015

2018 ◽  
Vol 46 (6) ◽  
pp. 637-642 ◽  
Author(s):  
Danielle L. Palms ◽  
Elisabeth Mungai ◽  
Taniece Eure ◽  
Angela Anttila ◽  
Nicola D. Thompson ◽  
...  
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
National Healthcare ◽  
National Healthcare Safety Network

Management of Extended-Spectrum Beta-Lactamase Urinary Tract Infections: Diagnostic and Treatment Considerations for the Older Adult

2019 ◽  
Vol 34 (10) ◽  
pp. 645-659
Author(s):  
Kalin M. Clifford ◽  
Jennifer L. Grelle ◽  
John C. Tawwater ◽  
Meenakshi Ramanathan ◽  
Nakia Duncan
Keyword(s):  
Urinary Tract ◽  
Long Term Care ◽  
Care Facility ◽  
Beta Lactamase ◽  
Term Care ◽  
Extended Spectrum Beta Lactamase ◽  
Long Term Care Facility ◽  
Extended Spectrum ◽  
Tract Infections

OBJECTIVE: To review the treatment options for extended-spectrum beta-lactamase (ESBL) urinary tract infections (UTIs) in the long-term care facility setting.<br/> DATA SOURCES: A PubMed search from January 1, 1990, through December 31, 2018, using terms "extended spectrum beta lactamase" and "urinary tract infection" was performed. Current guidelines, drug databases, and manufacturer package inserts were also used.<br/> STUDY SELECTION: All English-language articles during the above time frame appearing in these searches were reviewed for relevance to this paper. In addition, their bibliographies were reviewed to identify any articles not originally identified.<br/> DATA SYNTHESIS: ESBL UTIs are a growing concern in the long-term care facility as these pathogens are becoming more prevalent. Patients residing in long-term care facilities have fewer treatment modalities because of medication administration and care issues. This review highlights the data on different antibiotics and their efficacy toward ESBLs in the setting of UTI.<br/> CONCLUSIONS: Despite the challenges and limitations, there are still options for clinicians to provide optimal care, including antibiotics with different routes of administration, as well as different administration techniques. Clinicians can be successful with treating ESBL UTIs in older adults.

scholarly journals Nursing home adoption of the National Healthcare Safety Network Long-term Care Facility Component

2019 ◽  
Vol 47 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Andrew W. Dick ◽  
Jeneita M. Bell ◽  
Nimalie D. Stone ◽  
Ashley M. Chastain ◽  
Mark Sorbero ◽  
...  
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
National Healthcare ◽  
National Healthcare Safety Network

Management of Extended-Spectrum Beta-Lactamase Urinary Tract Infections: Diagnostic and Treatment Considerations for the Older Adult

2019 ◽  
Vol 34 (10) ◽  
pp. 645-659
Author(s):  
Kalin M. Clifford ◽  
Jennifer L. Grelle ◽  
John C. Tawwater ◽  
Meenakshi Ramanathan ◽  
Nakia Duncan
Keyword(s):  
Urinary Tract ◽  
Long Term Care ◽  
Care Facility ◽  
Beta Lactamase ◽  
Term Care ◽  
Extended Spectrum Beta Lactamase ◽  
Long Term Care Facility ◽  
Extended Spectrum ◽  
Tract Infections

OBJECTIVE: To review the treatment options for extended-spectrum beta-lactamase (ESBL) urinary tract infections (UTIs) in the long-term care facility setting.<br/> DATA SOURCES: A PubMed search from January 1, 1990, through December 31, 2018, using terms "extended spectrum beta lactamase" and "urinary tract infection" was performed. Current guidelines, drug databases, and manufacturer package inserts were also used.<br/> STUDY SELECTION: All English-language articles during the above time frame appearing in these searches were reviewed for relevance to this paper. In addition, their bibliographies were reviewed to identify any articles not originally identified.<br/> DATA SYNTHESIS: ESBL UTIs are a growing concern in the long-term care facility as these pathogens are becoming more prevalent. Patients residing in long-term care facilities have fewer treatment modalities because of medication administration and care issues. This review highlights the data on different antibiotics and their efficacy toward ESBLs in the setting of UTI.<br/> CONCLUSIONS: Despite the challenges and limitations, there are still options for clinicians to provide optimal care, including antibiotics with different routes of administration, as well as different administration techniques. Clinicians can be successful with treating ESBL UTIs in older adults.

No more nursing homes? Changes in consumer preferences for long-term care facilities following COVID-19

2020 ◽  
Vol 26 (11) ◽  
pp. 276-280
Author(s):  
Amber F Schultz ◽  
Jia Yu
Keyword(s):  
Nursing Homes ◽  
Long Term Care ◽  
Consumer Preferences ◽  
Care Facility ◽  
The Elderly ◽  
Term Care ◽  
Long Term Care Facility ◽  
Medical Disorders ◽  
Care Facilities

Since the first COVID-19 case was discovered in December 2019, over 12.1 million cases have been reported in more than 188 countries and territories. In the USA, the Centers for Disease Control and Prevention has confirmed almost 3.05 million COVID-19 cases, with more than 132 000 deaths. The COVID-19 pandemic has had a particularly dramatic impact on the elderly and those with chronic underlying medical disorders. Before the second outbreak in July, long-term care facilities were the most severely affected in terms of case numbers, especially nursing homes. This article provides information and insight into the potential changes in consumer preferences toward long-term care facility selection and the possible structural change of the long-term care industry in three aspects; structure, conduct and performance.

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