Antibiotic-resistant E. coli is on the rise in nursing homes, study shows

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An antibiotic-resistant strain of Escherichia coli (E. coli) is on the rise in long-term care facilities, according to a study in the April issue of Infection Control and Hospital Epidemiology.

Researchers led by Ritu Banerjee, M.D., Ph.D., of the Mayo Clinic in Rochester, MN, looked at nearly 300 cases of extraintestinal E. coli submitted to labs in Minnesota between February and March 2011. They found residence in a long-term care facility was the No. 1 predictor of ST131 infection. ST131 is an E. coli strain resistant to
fluoroquinolone antibiotics such as Cipro and Avelox.

The risk of contracting ST131 is eight times greater for long-term care residents than those not in an LTC setting, the researchers found. High levels of antibiotic exposure and “health-associated alterations in intestinal microbiota” likely contribute to ST131 infection among the long-term care group.

Nursing home staff should be alert to ST131 because individuals with this type of E. coli are often initially treated with ineffective antibiotics, which can cause the condition to worsen or recur, the researchers said.

"The finding … indicates an urgent need for improved antibiotic use and infection control practices,” Banerjee stated. “Efforts that focus on reducing overuse and misuse of fluoroquinolones are likely to have the greatest impact on ST131 prevalence, given the strong association between ST131 and fluoroquinolone resistance.”

This E. coli study comes shortly after the Centers for Disease Control and Prevention urged healthcare providers to reevaluate antibiotic practices in light of a deadly bacteria that spreads its antibiotic resistance to other germs.

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