title: Nursing home residents and Enterobacteriaceae resistant to third-generation cephalosporins.
abstract: Limited data identify the risk factors for infection with Enterobacteriaceae resistant to third-generation cephalosporins among residents of long-term-care facilities. Using a nested case-control study design, nursing home residents with clinical isolates of Enterobacteriaceae resistant to third-generation cephalosporins were compared to residents with isolates of Enterobacteriaceae susceptible to third-generation cephalosporins. Data were collected on antimicrobial drug exposure 10 weeks before detection of the isolates, facility-level demographics, hygiene facilities, and staffing levels. Logistic regression models were built to adjust for confounding variables. Twenty-seven case-residents were identified and compared to 85 controls. Exposure to any cephalosporin (adjusted odds ratio [OR] 4.0, 95% confidence interval [CI] 1.2 to 13.6) and log percentage of residents using gastrostomy tubes within the nursing home (adjusted OR 3.9, 95% CI 1.3 to 12.0) were associated with having a clinical isolate resistant to third-generation cephalosporins.
authors.affiliation: McMaster University, Hamilton, Ontario, Canada.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Sandoval
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Walter
authors.forename: Allison
authors.initials: A
authors.lastname: McGeer
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Simor
authors.forename: Suzanne F
authors.initials: SF
authors.lastname: Bradley
authors.forename: Lorraine M
authors.initials: LM
authors.lastname: Moss
authors.forename: Mark B
authors.initials: MB
authors.lastname: Loeb
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002170:Canada; D016022:Case-Control Studies; D002511:Cephalosporins / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000254:growth & development / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D016015:Logistic Models; D008826:Microbial Sensitivity Tests; D015999:Multivariate Analysis; D009735:Nursing Homes; D012307:Risk Factors; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins