title: Antimicrobial resistance and stewardship in long-term care settings.
abstract: Infections and antimicrobial resistance (AMR) in long-term care facilities (LTCFs) are a public health challenge and a future infectious disease threat. More and more data show the dimension and impact of AMR and of inappropriate use of antimicrobials in this setting. Recently, the spread of carbapenemase-producing Enterobacteriaceae has provided new insights into the dangerous role the long-term care sector may play in the AMR problem in a community. Implementation of effective infection and surveillance control programs in LTCFs is challenging, due to scarce resources (personnel, expertise, diagnostic and supportive services), and no or poor coordination of medical care. However, interventions in LTCFs have been proven to be effective: inappropriate use of antibiotics for asymptomatic bacteriuria may be reduced; hand hygiene compliance may be improved; and the transmission of multidrug-resistant organisms may be halted. This paper reviews the most recent epidemiological information on this issue, providing references to valuable intervention programs.
authors.affiliation: Infectious Risk Unit, Agenzia Sanitaria e Sociale Regione Emilia-Romagna, Bologna, Italy. mlmoro@regione.emilia-romagna.it
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Moro
authors.forename: Carlo
authors.initials: C
authors.lastname: Gagliotti
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D011307:Drug Prescriptions / Q000592:standards*; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization / Q000592:standards; D006291:Health Policy; D017053:Infection Control / Q000379:methods; D008134:Long-Term Care / Q000379:methods*; D016134:Organizational Policy
chemical_list: D000900:Anti-Bacterial Agents