were reviewed for resistant organisms (methicillin-resistant Staphylococcus aureus [MRSA], vancomycin-resistant enterococci [VRE], and resistant gram-negative bacilli). In the second study, residents admitted to the AGS during a 2-month period (n=92 admissions) had surveillance cultures (nares, gastrostomy site, wounds, and urine) for resistant organisms performed within 72 hours of admission. In the retrospective study, there were 727 admissions, of which 437 (60%) had 928 cultures within 72

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... urs of admission; 590 (64%) cultures grew one or more pathogens. Urine (65%) and blood (26%) cultures accounted for 91% of all cultures done. Rates of resistance by culture site were as follows: urine (resistant organism in 16.6% of 373 cultures), blood (6.7% of 60 cultures), wound (52% of 23 cultures), and sputum (40% of 20 cultures). MRSA and enterococci with high-level gentamicin resistance were the most common resistant organisms identified. No VRE were isolated; only 3% of 421 gram-negative isolates were considered resistant strains, compared with 19% (P<.001) of grampositive isolates. In the prospective study, 17% of 92 residents were found to have a resistant organism in 1 or more surveillance cultures; the most common resistant organisms were MRSA and high-level gentamicin-resistant enterococci. Only 1 resident was found to have VRE in a rectal swab culture; resistant gram-negative bacilli also were uncommon. The authors concluded that, among residents of community LTCFs admitted to an AGS, resistant organisms were identified infrequently (<20% of admissions). MRSA was the most common resistant organism; VRE and resistant gram-negative bacilli were rare. These findings vary from other studies suggesting that there may be geographic variation in the epidemiology of resistant organisms among residents of community LTCFs. FROM: Mylotte JM, Goodnough S, Tayara A. Antibiotic-resistant organisms among long-term care facility residents on admission to an inpatient geriatrics unit: retrospective and prospective surveillance. Am J Infect Control 2001;29:139-144.