The high-risk population and current lack of knowledge regarding appropriate infection prevention in the long-term care (LTC) setting has contributed to substantial rates of resistance and healthcare-associated infections in this arena. More evidence-based research on LTC is necessary, particularly now that the elderly population is increasing.
Proposed government mandates highlight the urgent need to combat antimicrobial resistance in the LTC setting. Recent studies focusing on unique strategies for the prevention of transmission and infection with multidrug-resistant organisms in nursing homes are discussed, as well as attempts to formulate clear antimicrobial stewardship programs.
The long-term setting has unique challenges to instituting effective infection control precautions, therefore current accepted methods used in acute-care facilities need to be modified. Recent data suggest that prevention of transmission in LTC may be achieved with focus on high-risk patients or specific care-based activities rather than colonization status. Antimicrobial stewardship and consultation with specialized physicians may be important measures to combat resistance and adverse events in LTC. The prevention of unnecessary antibiotic use in palliative care may reduce rates of resistance as well as discomfort for terminal patients.
aJohns Hopkins University, Department of Medicine, Division of Infectious Disease
bDepartment of Epidemiology and Public Health, University of Maryland School of Medicine, Geriatrics Research Education and Clinical Center, VA Maryland Healthcare System, Baltimore, Maryland, USA
Correspondence to Dr Morgan J. Katz, MD, Johns Hopkins University, Department of Medicine, Division of Infectious Disease, 1830 E Monument Street, Baltimore, MD 21287, USA. Tel: +1 410 245 1343; e-mail: firstname.lastname@example.org