title: Telephone Survey of Infection-Control and Antibiotic Stewardship Practices in Long-Term Care Facilities in Maryland.
abstract: Multidrug-resistant organisms are an emerging and serious threat to the care of patients. Long-term care facilities are considered a reservoir of these organisms partly because of the over-prescribing of antibiotics. Antibiotic use is common in long-term care facilities. Antibiotic stewardship programs have been shown to reduce antibiotic consumption in acute-care facilities. The purpose of our study is to investigate existing infection-control practices and antibiotic stewardship programs in long-term care facilities in Maryland.
  
  
  
  We telephoned the infection-control personnel in 231 long-term care facilities in Maryland between February 2014 and July 2015 and reached 124 facilities (59%).
  
  
  
  Among the 124 facilities surveyed, there were 14,371 beds and 337 infection-control personnel with basic infection-control training. Close to 20% of facilities use silver- or antimicrobial-impregnated urinary catheters. Most facilities (97%) track urinary tract infections. Although all report to the health department in the case of an outbreak, only 63 (50.8 %) report directly to the Centers for Disease Control and Prevention. About 80% of facilities isolate patients with Clostridium difficile, methicillin-resistant Staphylococcus aureus, and vancomycin-resistant Enterococci with acute infections only. Eighty percent of facilities have basic guidance on choice of antibiotic, and 27% have a restricted formulary. Only 25% of facilities have an antibiotic approval process. Thirty-five percent of facilities have training for antibiotics prescribing. However, 17% of facilities did not know whether such training existed.
  
  
  
  Antibiotic stewardship programs in long-term care facilities are still in early development stages, but our results demonstrate that the majority of facilities are collecting data on prescribing antibiotics, and a surprising number have antibiotic approval and antibiotics prescribing training.
authors: Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD. Electronic address: myang29@jhmi.edu.
authors: Mia
authors: M
authors: Yang
authors: Johns Hopkins Bayview Medical Center, Baltimore, MD.
authors: Karen
authors: K
authors: Vleck
authors: Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
authors: Michele
authors: M
authors: Bellantoni
authors: Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
authors: Geeta
authors: G
authors: Sood
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003140:Communicable Disease Control; D005260:Female; D006801:Humans; D008297:Male; D008396:Maryland; D009735:Nursing Homes; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents
keywords: Long-term care; Maryland; antibiotic stewardship; telephone survey