Antibiotic-Resistant Flora in Nursing Home Patients Admitted to the Hospital

doi:10.1001/archinte.1985.00360100064009

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Vol. 145 No. 10, October 1985

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Antibiotic-Resistant Flora in Nursing Home Patients Admitted to the Hospital

Robert P. Gaynes, MD; Robert A. Weinstein, MD; William Chamberlin, MD; Sherwin A. Kabins, MD

Arch Intern Med. 1985;145(10):1804-1807.

Abstract

• To study carriage of multiply resistant gram-negativebacilli, 50 patients admitted to the hospital from nursing homes(NHs) and 50 control admissions not from NHs were matched forage and recent antibiotic use. Their antibiotic resistance patternswere similar: 20 NH patients and 14 controls had resistant strains.However, significantly more patients (64%) from NHs with largenumbers of "skilled beds" had resistant bacteria than did patientsfrom small NHs (21%) or controls (28%). Also, more patientsfrom NHs had members of the Proteus-Providencia-Morganella groupin their urine than did controls. Discriminant analysis showedthat residence in NHs with large numbers of skilled beds, recentantibiotic use, and bladder dysfunction (indwelling catheteror incontinence) were independently important in predictingcarriage of resistant strains in NH and control patients. Over75% of resistant isolates were from rectal specimens, emphasizingthe occult way that such strains are brought into the hospital.

(Arch Intern Med 1985;145:1804-1807)

Author Affiliations

From the Infection Control Program and Division of Infectious Diseases, Department of Medicine, Michael Reese Hospital and Medical Center, Chicago, and the University of Chicago Pritzker School of Medicine.

Footnotes

Accepted for publication Jan 10, 1985.

Reprint requests to Department of Medicine, Michael Reese Hospitaland Medical Center, Lake Shore Drive at 31st Street, Chicago,IL 60616 (Dr Weinstein).

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