EPIDEMIOLOGY - ANTIMICROBIAL RESISTANCE PATTERNS IN LONG-TERM GERIATRIC CARE - IMPLICATIONS FOR DRUG-THERAPY

There is a high prevalence of bacterial infections in long term care f acilities (4.4 to 16.2%). This, together with the fact that antimicrob ial resistance is a big concern in current medical practice, makes inf ection control so important in nursing home care. This article covers the mechanisms of antibacterial resistance and focuses on 4 major anti bacterial-resistant bacteria. Vancomycin is the treatment of choice fo r methicillin-resistant Staphylococcus aureus (MRSA). Colonisation wit h MRSA is not uncommon in nursing homes and eradication is probably no t necessary. Any clinically important enterococcal infection should be tested for high-level resistance. An infectious disease consultation should be sought for vancomycin-resistant enterococcal infections. Gra m-negative bacilli have developed multiresistance. Susceptibility test ing can identify the most appropriate therapy. Multiresistance should also be considered when treating Streptococcus pneumoniae. Overall, ha ndwashing is highly recommended. Barrier precautions, minimising hospi talisations and avoiding unnecessary personnel rotation can reduce the chance of resistance spread.