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Antibiotic resistance in the institutionalized elderly.
Andrea M Hujer1, Christopher R Bethel, Kristine M Hujer
1Research Service, Louis Stokes Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, Ohio 44106, USA.
Clinics in Laboratory Medicine
|June 5, 2004
Summary
Long term care facilities (LTCFs) face rising antibiotic resistance, particularly ceftazidime resistance in Gram-negative bacteria due to beta-lactamase enzymes. Understanding these enzymes is crucial for infection control in geriatric care.
Area of Science:
- Microbiology
- Infectious Diseases
- Geriatric Medicine
Background:
- Long term care facilities (LTCFs) are integral to healthcare, housing many elderly patients.
- Infections are a major cause of illness and death in LTCFs.
- Increased antibiotic use in LTCFs drives the emergence of multidrug-resistant organisms.
Purpose of the Study:
- To summarize the diversity of beta-lactamases.
- To highlight enzymes conferring ceftazidime resistance in LTCFs.
- To detail methods for identifying and characterizing these enzymes.
Main Methods:
- Review of beta-lactamase diversity.
- Focus on enzymes causing ceftazidime resistance in Gram-negative bacteria.
- Description of identification and characterization techniques.
Main Results:
- Beta-lactamase production is the primary mechanism for ceftazidime resistance in Gram-negative bacteria.
- Resistance to ceftazidime is frequently observed among third-generation cephalosporins.
- Specific beta-lactamases are key contributors to ceftazidime resistance in LTCF settings.
Conclusions:
- Beta-lactamase enzymes are critical for understanding and combating ceftazidime resistance in LTCFs.
- Developing and applying molecular and epidemiologic studies in LTCFs is essential.
- Effective strategies are needed to manage antibiotic resistance in these vulnerable populations.