title: Antibiotic-resistant gram-negative organisms in pediatric chronic-care facilities.
abstract: This study was designed to define the prevalence of colonization with antibiotic-resistant gram-negative rectal specimens were obtained from subjects residing in 2 pediatric extended-care facilities and were processed to identify gram-negative organisms resistant to ceftazidime, gentamicin, meropenem, and piperacillin-tazobactam. Horizontal transmission was assessed by analyzing all resistant isolates by pulsed-field gel electrophoresis. Forty percent of subjects were colonized with >/=1 resistant bacillus; >60% of organisms were resistant to >/=2 of the antibiotics tested. Colonization was disproportionate among residents with a tracheostomy or other prosthesis. More than 65% of colonized subjects shared 1 organism with another resident, with cross-colonization occurring among both enteric and nonenteric species. Children residing in chronic-care facilities represent a large reservoir for resistant bacilli. Such colonization may be amenable to simple barrier infection-control procedures.
authors.affiliation: Department of Pediatrics, Rainbow Babies and Children's Hospital of the University Hospitals of Cleveland, Cleveland, OH, 44106, USA. karen.lidsky@uhhs.com
authors.forename: Karen
authors.initials: K
authors.lastname: Lidsky
authors.forename: Claudia
authors.initials: C
authors.lastname: Hoyen
authors.forename: Ann
authors.initials: A
authors.lastname: Salvator
authors.forename: Louis B
authors.initials: LB
authors.lastname: Rice
authors.forename: Philip
authors.initials: P
authors.lastname: Toltzis
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002654:Child Care; D002675:Child, Preschool; D018562:Disease Transmission, Infectious; D024881:Drug Resistance, Bacterial / Q000502:physiology*; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000502:physiology*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000635:transmission; D006801:Humans; D008297:Male; D012307:Risk Factors