title: Fluoroquinolone-resistant Escherichia coli in the long-term care setting.
abstract: BACKGROUND
  Prior studies have found fluoroquinolone exposure to be a risk factor for infection with fluoroquinolone-resistant gram-negative rods in the acute care setting. However, risk factors may be different in the long-term care setting.
  
  
  METHODS
  A case-control study design was used to determine whether fluoroquinolone exposure is a risk factor for fluoroquinolone-resistant Escherichia coli urinary tract infections in a long-term care center. Cases had fluoroquinolone-resistant E. coli urinary tract infections; 4 controls were selected for each case.
  
  
  RESULTS
  Thirty-three case patients were eligible; 132 controls were then selected. In the multivariable analysis, fluoroquinolone-resistant E. coli urinary tract infection was more common with prior fluoroquinolone use (odds ratio 21.8, 95% confidence interval, 3.7-127.1).
  
  
  CONCLUSIONS
  Prior fluoroquinolone use is a strong risk factor for fluoroquinolone-resistant E. coli urinary tract infection in the long-term care setting. Further studies are needed to examine the effect of interventions to decrease fluoroquinolone-resistant infections in the long-term care setting, including studying the effect of decreasing fluoroquinolone use.
authors.affiliation: Columbia University, Department of Medicine, New York, NY, USA.
authors.forename: Alana E
authors.initials: AE
authors.lastname: Cohen
authors.forename: Ebbing
authors.initials: E
authors.lastname: Lautenbach
authors.forename: Knashawn H
authors.initials: KH
authors.lastname: Morales
authors.forename: Darren R
authors.initials: DR
authors.lastname: Linkin
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects*; D004927:Escherichia coli Infections / Q000188:drug therapy*; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009735:Nursing Homes; D015143:Philadelphia; D014481:United States; D014493:United States Department of Veterans Affairs; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones