Differing bacteria, resistance patterns of nursing home and community patients

January 01, 0001

Differing bacteria, resistance patterns of nursing home and community patients

Nursing home-acquired infections may differ from general community-acquired infections in bacteriology and antibiotic resistance. However, there is currently limited data on this topic in the Australian setting. The aim of this study by researchers from Melbourne, Australia was to compare bacterial isolates and antibiotic resistance patterns, from pathology specimens of nursing home and community patients, and to comment on the suitability of empiric antibiotic guidelines for nursing-home acquired infection. This was a retrospective cohort study of patients, aged=65 years, who resided in either nursing homes or the general community. Patients with a hospital admission in the previous 28 days were excluded. Positive specimen cultures, collected between July 2003 and June 2008 in the Emergency Department and Outpatient Clinics of the Austin Hospital (Melbourne), were examined.

The bacteriology of blood culture isolates did not differ between the two groups. However, the bacteriology of sputum, urine and wound cultures differed significantly between the groups. There were also higher proportions of antibiotic resistance among some bacteria in nursing home patients, especially methicillin resistance among Staphylococcus aureus isolates across all specimen types, and resistance to several empiric antibiotics among Enterobacteriaceae isolates in urine cultures.

The researchers concluded: "Empiric antibiotic guidelines appear adequate to treat nursing home-acquired septicaemia and pneumonia. However, guidelines for urinary tract infections and wound infections may need to be refined."

This probably reflects what is happening universally in ‘nursing homes’. Knowledge about local conditions is important.

For the full abstract, click here.

Internal Medical Journal published online 17 January 2011
© 2011 Royal Australasian College of Physicians
Comparison of the bacterial isolates and antibiotic resistance patterns of elderly nursing home and general community patients. Charles Xie, David McD. Taylor, Benjamin P Howden, Patrick GP Charles. Correspondence to A/Prof David Taylor: [email protected]

Category: HSR. Health Services Research. Keywords: bacterial infections, nursing homes, drug resistance, bacterial, urinary tract infections, methicillin- resistant staphylococcus aureus, retrospective cohort study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 4 February 2011

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