[The threat of antibiotic resistance to nursing homes]

Antibiotic resistance is considered a major threat to healthcare. The Dutch government recently announced additional measures to contain this threat, one of these being the creation of regional care networks dedicated to control antibiotic resistance. Among the anticipated activities of these networks is quantifying the prevalence of antibiotic resistance in nursing homes, through regular point-prevalence surveillance studies. There is a broadly felt belief that nursing homes might be a 'mer à boire' of antibiotic resistance. Although scientific data do not support that claim, it is nevertheless likely that the planned investigations will identify yet unknown clusters of ESBL-carriers, necessitating infection control measures. Given the absence of an acute problem and the consequences for nursing home management, staff and clients of point-prevalence surveillance studies, a staged approach for investigating antibiotic resistance in nursing homes should be considered.