title: The prevalence of ESBL-producing Enterobacteriaceae in a nursing home setting compared with elderly living at home: a cross-sectional comparison.
abstract: BACKGROUND
  The aim of the study was to investigate the prevalence of faecal carriage of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae among residents living in nursing homes and to compare it with a corresponding group of elderly people living in their own homes.
  
  
  METHODS
  A total of 160 persons participated in the study between February and April 2014, 91 were residents in nursing homes (n = 10) and the remaining 69 were elderly living in their own homes. In addition to performing faecal samples, all participants answered a standardized questionnaire regarding known risk factors for ESBL-carriage.
  
  
  RESULTS
  There was no significant difference between the groups, as 10 of the 91 (11%) residents from nursing homes were ESBL-carriers compared with 6 of 69 (8,7%) elderly living in their own homes. There was no significant difference between the groups. The total prevalence was 10%. A univariate analysis revealed that the only studied risk factor significantly associated with ESBL-carriage was recent foreign travel (p = 0,017). All ESBL-positive isolates were Escherichia coli and there was a high degree of co-resistance to other antibiotics. All isolates (n = 17) were susceptible to imipenem and amikacin.
  
  
  CONCLUSIONS
  Residents of nursing homes as well as elderly living in their own homes have high rates of faecal carriage of ESBL-producing bacteria. These findings may affect the choice of empirical antibiotic treatment of severe infections in older adults.
authors.affiliation: Infectious Diseases Research Unit, Deptment of Clinical sciences, Lund University, Skånes University hospital, 205 02, Malmö, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Blom
authors.affiliation: Infectious Diseases Research Unit, Deptment of Clinical sciences, Lund University, Skånes University hospital, 205 02, Malmö, Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Ahl
authors.affiliation: Infectious Diseases Research Unit, Deptment of Clinical sciences, Lund University, Skånes University hospital, 205 02, Malmö, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Månsson
authors.affiliation: Infectious Diseases Research Unit, Deptment of Clinical sciences, Lund University, Skånes University hospital, 205 02, Malmö, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Resman
authors.affiliation: Infectious Diseases Research Unit, Deptment of Clinical sciences, Lund University, Skånes University hospital, 205 02, Malmö, Sweden. johan.tham@med.lu.se.
authors.forename: Johan
authors.initials: J
authors.lastname: Tham
mesh_terms: D000368:Aged; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D003430:Cross-Sectional Studies; D004755:Enterobacteriaceae / Q000187:drug effects / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D006801:Humans; D009735:Nursing Homes; D015995:Prevalence; D012307:Risk Factors; D018440:beta-Lactam Resistance