title: Multiple antibiotic-resistant bacteria in long-term-care facilities: An emerging problem in the practice of infectious diseases.
abstract: Long-term-care facilities (LTCFs) are becoming a major component of the health care delivery system. The management of infections with antibiotic-resistant bacteria in elderly patients in LTCFs is presenting new challenges to our current therapeutic armamentarium. Among the enteric bacilli, resistance to ceftazidime, beta-lactam/beta-lactamase-inhibitor combinations, and trimethoprim-sulfamethoxazole present the foremost problems. Quinolone-resistant gram-negative and gram-positive bacteria are increasing in frequency because of the widespread use of these agents in empirical treatment. Among the resistant gram-positive organisms, methicillin-resistant Staphylococcus aureus, penicillin-resistant pneumococci, and vancomycin-resistant enterococci are the most feared pathogens. Education, antibiotic control measures, and fundamental epidemiological and scientific research are advocated as important preventive measures.
authors.affiliation: Geriatric Care Center, University Hospitals of Cleveland, OH, USA. rab14@po.cwru.edu
authors.forename: R A
authors.initials: RA
authors.lastname: Bonomo
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001419:Bacteria / Q000187:drug effects*; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D006268:Health Facilities; D006801:Humans; D008134:Long-Term Care
chemical_list: D000900:Anti-Bacterial Agents