Multiply Antibiotic-Resistant Gram-Negative Bacilli in a Long-Term-Care Facility: A Case-Control Study of Patient Risk Factors and Prior Antibiotic Use

1997 ◽  
Vol 18 (12) ◽  
pp. 809-813 ◽  
Author(s):  
Robert R. Muder ◽  
Carole Brennen ◽  
Stephanie D. Drenning ◽  
Janet E. Stout ◽  
Marilyn M. Wagener
Keyword(s):  
Long Term Care ◽  
Case Control Study ◽  
Care Facility ◽  
Antibiotic Use ◽  
Case Control ◽  
Term Care ◽  
Antibiotic Resistant ◽  
Long Term Care Facility ◽  
Control Study

Multiply Antibiotic-Resistant Gram-Negative Bacilli in a Long-Term-Care Facility: A Case-Control Study of Patient Risk Factors and Prior Antibiotic Use

1997 ◽  
Vol 18 (12) ◽  
pp. 809-813 ◽  
Author(s):  
Robert R. Muder ◽  
Carole Brennen ◽  
Stephanie D. Drenning ◽  
Janet E. Stout ◽  
Marilyn M. Wagener
Keyword(s):  
Long Term Care ◽  
Case Control Study ◽  
Care Facility ◽  
Antibiotic Use ◽  
Case Control ◽  
Term Care ◽  
Antibiotic Resistant ◽  
Long Term Care Facility ◽  
Control Study

Multiply Antibiotic Resistant Gram-Negative Bacilli in a Long Term Care Facility A Case Control Study of Patient rick Factors and Prior Antibiotic Use

1997 ◽  
Vol 18 (12) ◽  
pp. 809-813
Author(s):  
Robert R Muder ◽  
Carole Brennen ◽  
Stephanie D. Drenning ◽  
Janet E. Stout ◽  
Marilyn M. Wagener
Keyword(s):  
Long Term Care ◽  
Case Control Study ◽  
Care Facility ◽  
Case Control ◽  
Prior Exposure ◽  
Decubitus Ulcers ◽  
Term Care ◽  
Long Term Care Facility ◽  
Control Study

AbstractObjective:To determine the relation between prior exposure to specific antimicrobials and acquisition of gram-negative bacilli resistant to multiple ß-lactam and aminoglycoside antibiotics among long-term-care patients.Design:Case-control study. Cases were patients from whom multiply resistantEnterobacteriaceaeorPseudomonas aeruginosawere isolated; controls were patients from whom nonresistant bacteria of the same species were isolated. Prospectively defined risk factors included underlying illness, activity level, presence of decu-bitus ulcers, presence of indwelling devices, and prior exposure to specific antimicrobial agents. Resistant and control isolates ofP aeruginosawere compared using pulsed-field gel electrophoresis (PFGE) of genomic DNA after digestion withXbaI.Setting:390-bed long-term Veterans' Affairs facility.Results:We identified 35 patients with multiply resistantEnterobacteriaceaeand 24 patients with multiply resistantP aeruginosa. Of the resistantEnterobacteriaceae, 87% of isolates were resistant to piperacillin, 55% to ceftazidime, and 90% to gentamicin. Acquisition of multiply resistantEnterobacteriaceaewas associated with presence of decubitus ulcers (odds ratio [OR], 12.2; 95% confidence interval [CI95], 3.3-44.2;P=.0002) and prior receipt of ampicillm (OR, 13.7; CI95, 2.2-84;P=.005). Of resistant isolates ofP aeruginosa, 88% were resistant to piperacillin, 25% to ceftazidime, 42% to imipenem, and 67% to ciprofloxacin. Isolation of a multiply resistantP aeruginosawas associated with total days of antimicrobial exposure (OR, 1.07; CI95, 1.01-1.12;P=.011) and not with prior receipt of any individual agent. Eleven multiply resistant isolates shared a common PFGE pattern.Conclusions:In our long-term-care facility, acquisition of multiply resistantEnterobacteriaceaewas associated with the presence of decubitus ulcers and prior exposure to ampicillin. Acquisition of resistantP aeruginosawas associated with total antibiotic exposure. Molecular typing ofP aeruginosaisolates implicated patient-to-patient transmission of a limited number of resistant strains.

A Case Control Study of the Risks for Institutionalization of Elderly People in Nova Scotia

1994 ◽  
Vol 13 (1) ◽  
pp. 104-117 ◽  
Author(s):  
Katherine Glazebrook ◽  
Kenneth Rockwood ◽  
Paul Stolee ◽  
John Fisk ◽  
J. M. Gray
Keyword(s):  
Nova Scotia ◽  
Elderly People ◽  
Functional Impairment ◽  
Long Term Care ◽  
Case Control Study ◽  
The Elderly ◽  
Case Control ◽  
Term Care ◽  
Control Study

ABSTRACTFew studies of the risks of institutionalization of the elderly have had fully specified models using multivariate analysis, and several studies have examined highly selected populations, making their generalizability uncertain. We set out to examine the risks of institutionalization in elderly people in Nova Scotia. A case-control study, executed as part of the Canadian Study of Health and Aging examined 108 incident institutional cases and 533 community-dwelling elderly controls, using a standardized assessment interview conducted by trained interviewers. Multiple logistic regression analysis showed that advancing age, presence of dementia, functional impairment, poor self-rated health, recent hospital admission, and absence of a caregiver were important risks for entry into long term care. Institutions providing long-term care for the elderly need to be able to look after populations with a high prevalence of dementia and functional impairment.

scholarly journals Colonization and Infection with Antibiotic-Resistant Bacteria in a Long-Term Care Facility

1994 ◽  
Vol 42 (10) ◽  
pp. 1062-1069 ◽  
Author(s):  
Margaret S. Terpenning ◽  
Suzanne F. Bradley ◽  
Jim Y. Wan ◽  
Carol E. Chenoweth ◽  
Karen A. Jorgensen ◽  
...  
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Resistant Bacteria ◽  
Antibiotic Resistant Bacteria ◽  
Term Care ◽  
Antibiotic Resistant ◽  
Term Care Facility ◽  
Long Term Care Facility

Statin use and fall-related hospitalizations among residents of long-term care facilities: A case-control study

2020 ◽  
Vol 14 (4) ◽  
pp. 507-514
Author(s):  
Kate N. Wang ◽  
J Simon Bell ◽  
Edwin CK. Tan ◽  
Julia FM. Gilmartin-Thomas ◽  
Michael J. Dooley ◽  
...  
Keyword(s):  
Long Term Care ◽  
Case Control Study ◽  
Case Control ◽  
Term Care ◽  
Care Facilities ◽  
Control Study ◽  
Statin Use

scholarly journals Antibiotic Use and Need for Antimicrobial Stewardship in Long-Term Care

2015 ◽  
Vol 68 (6) ◽  
Author(s):  
Lisa Dong-Ying Wu ◽  
Sandra A N Walker ◽  
Marion Elligsen ◽  
Lesley Palmay ◽  
Andrew Simor ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
Care Facility ◽  
Antibiotic Use ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Longue Duree ◽  
Longue Durée

<p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Antimicrobial stewardship may be important in long-term care facilities because of unnecessary or inappropriate antibiotic use observed in these residents, coupled with their increased vulnerability to health care–associated infections.</p><p><strong>Objectives:</strong> To assess antibiotic use in a long-term care facility in order to identify potential antimicrobial stewardship needs.</p><p><strong>Methods:</strong> A retrospective descriptive study was conducted at the Veterans Centre, a long-term care facility at Sunnybrook Health Sciences Centre, Toronto, Ontario. All residents taking one or more antibiotics (n = 326) were included as participants. Antibiotic-use data for patients residing in the facility between April 1, 2011, and March 31, 2012, were collected and analyzed.</p><p><strong>Results:</strong> Totals of 358 patient encounters, 835 antibiotic prescriptions, and 193 positive culture results were documented during the study period. For 36% (302/835) of antibiotic prescriptions, the duration was more than 7 days. Cephalosporins (30%; 251/835) and fluoroquinolones (28%; 235/835) were the most frequently prescribed antibiotic classes. Urine was the most common source of samples for culture (60%; 116/193).</p><p><strong>Conclusions:</strong> Characteristics of antimicrobial use at this long-term care facility that might benefit from further evaluation included potentially excessive use of fluoroquinolones and cephalosporins and potentially excessive duration of antibiotic use for individual patients.</p><p><strong>RÉSUMÉ</strong></p><p><strong></strong><strong>Contexte :</strong> La gérance des antibiotiques peut s’avérer importante au sein des établissements de soins de longue durée à cause d’une utilisation inutile ou inappropriée des antibiotiques chez les résidents de ces établissements et de leur vulnérabilité aux infections nosocomiales. </p><p><strong>Objectifs :</strong> Évaluer l’utilisation des antibiotiques dans un établissement de soins de longue durée afin de déterminer si une gérance des antimicrobiens peut être nécessaire.</p><p><strong>Méthodes :</strong> Une étude descriptive rétrospective a été réalisée au Veterans Centre, un établissement de soins de longue durée au sein du Sunnybrook Health Sciences Centre, à Toronto en Ontario. Tous les résidents prenant au moins un antibiotique (n = 326) ont été admis à l’étude. Des données sur les antibiothérapies pour des patients résidant dans l’établissement entre le 1er avril 2011 et le 31 mars 2012 ont été recueillies et analysées.</p><p><strong>Résultats :</strong> Pendant l’étude, on a consigné en tout 358 séjours de patients, 835 prescriptions d’antibiotiques et 193 résultats positifs de culture. Pour 36 % (302/835) des prescriptions d’antibiotiques, le traitement était de plus de 7 jours. Les céphalosporines (30 % [251/835]) et les fluoroquinolones (28 % [235/835]) étaient les antibiotiques les plus souvent prescrits. Les cultures étaient le plus souvent obtenues à partir d’urines (60 % [116/193]).</p><p><strong>Conclusions :</strong> L’utilisation possiblement excessive de fluoroquinolones et de céphalosporines ainsi que la durée potentiellement exagérée des antibiothérapies font partie des caractéristiques de l’emploi des antimicrobiens dans cet établissement de soins de longue durée qui pourraient mériter de plus amples évaluations.</p>

Proton Pump Inhibitors and Infection-Related Hospitalizations Among Residents of Long-Term Care Facilities: A Case–Control Study

Drugs & Aging ◽  
2019 ◽  
Vol 36 (11) ◽  
pp. 1027-1034 ◽  
Author(s):  
Kate N. Wang ◽  
J. Simon Bell ◽  
Edwin C. K. Tan ◽  
Julia F. M. Gilmartin-Thomas ◽  
Michael J. Dooley ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Long Term Care ◽  
Case Control Study ◽  
Case Control ◽  
Term Care ◽  
Care Facilities ◽  
Control Study
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