Abstract
Between 2000 and 2020, the percentages of the population 65 years and older in Canada
and the United States will increase by 43% and 33%, respectively (Anderson GF, Hussey
PS. Health Affairs 2000;19 (3): 191-203). In the United States alone, approximately
6 million persons need some type of long-term care; one third of these persons receive
this care in long-term care facilities, with an estimate that demand for this type
of care will double in the next 30 years, reflecting, in part, the aging population
(Feder J, et al. Health Affairs 2000;19(3):40-56). Presence of an antimicrobial resistant
strain in a patient always has been a factor during interfacility transfers—not infrequently
an impediment to smooth transitions in care. In continuation of the theme of antimicrobial
resistance, Dr Nicolle and ican PREVENT.com, an Internet based, peer-reviewed knowledge
aggregator, have agreed to provide the following thought-provoking commentary for
this installment of Reaction & Response that addresses the unique aspects of care
of patients with such microbial strains in long-term care.
QUESTION: Does antimicrobial resistance matter in long-term care facilities?
The following response has been provided by Lindsay E. Nicolle, MD, professor and
head of the Depart- ment of Internal Medicine, University of Manitoba, Winnipeg, Canada.
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References
- Infections and antibiotic resistance in nursing homes.Clin Microbiol Rev. 1996; 9: 1-17
- Microbiologic survey of long-term care facilities.Am J Infect Control. 2000; 28: 8-13
- Methicillin-resistant Staphylococcus aureus in extended care facilities: Experiences in a Veteran's Affairs nursing home and a review of the literature.Infect Control Hosp Epidemiol. 1991; 12: 36-45
- Methicillin-resistant Staphylococcus aureus: colonization and infection in a long-term care facility.Ann Intern Med. 1991; 115: 417-422
- Colonization with vancomy-cin-resistant Enterococcus faecium: comparison of a long-term care unit with an acute-care hospital.Infect Control Hosp Epidemiol. 1997; 18: 333-339
- Methicillin-resistant staphylococcal colonization and in-fection in a long-term care facility.Ann Intern Med. 1991; 114: 107-112
- Outbreak of ceftazidime resistance caused by ex- tended-spectrum B-lactamases at a Massachusetts chronic-care facility.Antimicrob Agents Chemother. 1990; 34: 2193-2199
- Antimicrobial resistance in long-term-care facilities.Infect Con- trol Hosp Epidemiol. 1996; 17: 129-140
- Antimicrobial use in long-term-care facilities.Infect Control Hosp Epidemiol. 2000; 21: 537-545
Article info
Footnotes
*Reprinted with permission from icanPREVENT. Published July 21, 2000. Available at: www.icanprevent.com.
**AJIC Am J Infect Control 2000;28:472-4
Identification
Copyright
© 2000 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
