title: Fluoroquinolone-resistant Escherichia coli carriage in long-term care facility.
abstract: We conducted a cross-sectional study to determine the prevalence of, and risk factors for, colonization with fluoroquinolone (FQ)-resistant Escherichia coli in residents in a long-term care facility. FQ-resistant E. coli were identified from rectal swabs for 25 (51%) of 49 participants at study entry. On multivariable analyses, prior FQ use was the only independent risk factor for FQ-resistant E. coli carriage and was consistent for FQ exposures in the previous 3, 6, 9, or 12 months. Pulsed-field gel electrophoresis of FQ-resistant E. coli identified clonal spread of 1 strain among 16 residents. Loss (6 residents) or acquisition (7 residents) of FQ-resistant E. coli was documented and was associated with de novo colonization with genetically distinct strains. Unlike the case in the hospital setting, FQ-resistant E. coli carriage in long-term care facilities is associated with clonal spread.
authors.affiliation: Veterans Affairs Medical Center, Philadelphia, Pennsylvania 19104, USA. joel.maslow@med.va.gov
authors.forename: Joel N
authors.initials: JN
authors.lastname: Maslow
authors.forename: Betsy
authors.initials: B
authors.lastname: Lee
authors.forename: Ebbing
authors.initials: E
authors.lastname: Lautenbach
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002353:Carrier State / Q000382:microbiology*; D015169:Colony Count, Microbial; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology*; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009735:Nursing Homes; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones