Risk Factors for Antibiotic-Resistant Infection and Treatment Outcomes among Hospitalized Patients Transferred from Long-Term Care Facilities: Does Antimicrobial Choice Make a Difference?

• Published in: Clinical infectious diseases Vol. 36; no. 6; pp. 724 - 730
• Main Authors: Toubes, E., Singh, K., Yin, D., Lyu, R., Glick, N., Russell, L., Mohapatra, S., Saghal, N., Weinstein, R. A., Trenholme, G.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15-03-2003; University of Chicago Press
• Subjects: Aged; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacteria; Biological and medical sciences; Catheters; Coinfection; Cross Infection - drug therapy; Cross Infection - economics; Cross Infection - epidemiology; Cross Infection - microbiology; Drug Prescriptions; Drug Resistance; Female; Hospital admissions; Hospitalization; Hospitalization - economics; Humans; Infections; Long-Term Care; Major Articles; Male; Medical sciences; Pathogens; Pharmacology. Drug treatments; Predisposing factors; Prospective Studies; Resource Allocation; Risk Factors; Staphylococcus aureus - isolation & purification; Teaching hospitals; Treatment Outcome; Human; Infection; Resistance; Antibiotic; Choice; Prognosis; Treatment; Risk factor; Hospitalization; Antibacterial agent; Homes for the aged; Antimicrobial agent
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/368081

A prospective observational study of 153 patients transferred from long-term care facilities and admitted to acute-care hospitals who had microbiologically confirmed infections was undertaken to determine the risk factors, outcomes, and resource use associated with isolation of antibiotic-resistant bacteria (ARB). Eighty patients (52%) were infected with ARB. In multivariable logistic analysis, the presence of a feeding tube (odds ratio, 3.0) or polymicrobial infection (odds ratio, 4.6) was associated with isolation of ARB. Forty-nine percent of patients infected with ARB received an initial antibiotic regimen to which their isolate was not susceptible. Fifty-one percent of all patients had a change in their antibiotic regimen during their hospital course. For these patients, length of stay, number of days of antibiotic therapy, and cost of hospitalization were significantly higher. However, neither infection with ARB nor appropriateness of initial treatment regimen was significantly related to outcome or resource use.