title: Low level of antimicrobial resistance in Escherichia coli among Swedish nursing home residents.
abstract: BACKGROUND
  Screening for bacterial colonization and antimicrobial resistance (AMR) among a defined population could aid in the identification of at-risk populations and provide targets for antibiotic stewardship and infection control programmes.
  
  
  METHODS
  Two hundred and sixty-eight participants at 11 Swedish nursing homes underwent serial screening for colonization with Escherichia coli between March 2008 and September 2010. Seventy-two of the 268 participants (27%) were male. The median age was 85 y. Samples were collected from urine, the rectal mucosa, the groin, and active skin lesions.
  
  
  RESULTS
  Two hundred and nine of 268 participants (78%) were colonized with E. coli at any body site/fluid. The specific colonization rates were 81% (rectum), 48% (urine), 30% (groin), 59% (unknown), and 13% (skin lesion). An antibiotic-resistant E. coli isolate was identified in 18% of all participants regardless of colonization status; all together, 87 resistant isolates were detected. Only 1 participant carried isolates with resistance to third-generation cephalosporins (cefotaxime and ceftazidime).
  
  
  CONCLUSIONS
  The presence of resistance was generally low, and the greater part of the resistant cases was connected with 3 common antibiotics: ampicillin, trimethoprim/sulfamethoxazole, and ciprofloxacin. In spite of generally increasing resistance against third-generation cephalosporins in E. coli in Sweden, this study does not implicate residence at a Swedish nursing home as a risk factor for the acquisition of expressed cephalosporin resistance.
authors.affiliation: Ödeshög Health Care Centre, Ödeshög, Sweden. magnus.olofsson@lio.se
authors.forename: Magnus
authors.initials: M
authors.lastname: Olofsson
authors.forename: Michael
authors.initials: M
authors.lastname: Toepfer
authors.forename: Carl Johan
authors.initials: CJ
authors.lastname: Ostgren
authors.forename: Patrik
authors.initials: P
authors.lastname: Midlöv
authors.forename: Andreas
authors.initials: A
authors.lastname: Matussek
authors.forename: Per-Eric
authors.initials: PE
authors.lastname: Lindgren
authors.forename: Sigvard
authors.initials: S
authors.lastname: Mölstad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology* / Q000652:urine; D005260:Female; D006119:Groin / Q000382:microbiology; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D015995:Prevalence; D012007:Rectum / Q000382:microbiology; D012867:Skin / Q000382:microbiology; D013548:Sweden / Q000453:epidemiology; D014556:Urine / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents