{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T01:19:15Z","timestamp":1793841555268,"version":"4.6.1"},"reference-count":25,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2020,8,12]],"date-time":"2020-08-12T00:00:00Z","timestamp":1597190400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X20003487_as1\"><jats:title>Objective:<\/jats:title><jats:p>Antibiotic resistance (AR) is a growing and highly prevalent problem in nursing homes. We describe selected AR phenotypes from pathogens causing urinary tract infections (UTIs) reported by nursing homes to the National Healthcare Safety Network (NHSN).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20003487_as2\"><jats:title>Design:<\/jats:title><jats:p>Pathogens and antibiotic susceptibility testing results for UTI events in nursing homes between January 2013 and December 2017 were analyzed. The pathogen distribution and pooled mean proportion of isolates that tested resistant to select antibiotic agents are reported.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20003487_as3\"><jats:title>Setting and Participants:<\/jats:title><jats:p>US nursing homes voluntarily participating in the Long-Term Care Facility component of the NHSN.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20003487_as4\"><jats:title>Results:<\/jats:title><jats:p>Overall, 243 nursing homes reported 1 or more UTIs: 121 (50%) were nonprofit facilities, median bed size was 91 (range: 9\u2013801), and average occupancy was 87%. In total, 6,157 pathogens were reported for 5,485 UTI events. Moreover, 9 pathogens accounted for 90% of all reported UTIs; the 3 most frequently identified were <jats:italic>Escherichia coli<\/jats:italic> (41%), <jats:italic>Proteus<\/jats:italic> species (14%), and <jats:italic>Klebsiella pneumoniae<\/jats:italic>\/<jats:italic>oxytoca<\/jats:italic> (13%). Among <jats:italic>E. coli<\/jats:italic>, fluoroquinolone, and extended-spectrum cephalosporin resistance were most prevalent (50% and 20%, respectively). Although <jats:italic>Staphylococcus aureus<\/jats:italic> and <jats:italic>Enterococcus faecium<\/jats:italic> represented &lt;5% of pathogens reported, they had the highest rates of resistance (67% methicillin resistant and 60% vancomycin resistant, respectively). Multidrug resistance was most common in <jats:italic>Pseudomonas aeruginosa<\/jats:italic> (11%). For the resistant phenotypes we assessed, 36% of all UTIs reported were associated with a resistant pathogen.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20003487_as5\"><jats:title>Conclusions:<\/jats:title><jats:p>This is the first summary of AR among common pathogens causing UTIs reported to NHSN by nursing homes. Improved understanding of the resistance burden among common infections helps inform facility infection prevention and antibiotic stewardship efforts.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2020.348","type":"journal-article","created":{"date-parts":[[2020,8,12]],"date-time":"2020-08-12T07:47:20Z","timestamp":1597218440000},"page":"31-36","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":17,"title":["Antibiotic-resistant pathogens associated with urinary tract infections in nursing homes: Summary of data reported to the National Healthcare Safety Network Long-Term Care Facility Component, 2013\u20132017"],"prefix":"10.1017","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6471-485X","authenticated-orcid":false,"given":"Taniece R.","family":"Eure","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimalie D.","family":"Stone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth A.","family":"Mungai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeneita M.","family":"Bell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola D.","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,8,12]]},"reference":[{"key":"S0899823X20003487_ref3","first-page":"33","article-title":"Urinary tract infections in older adults residing in long-term care facilities","volume":"20","author":"Genao","year":"2012","journal-title":"Ann Long-Term Care"},{"key":"S0899823X20003487_ref17","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.108"},{"key":"S0899823X20003487_ref2","unstructured":"2. Antibiotic resistant threats in the United States, 2019. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/drugresistance\/pdf\/threats-report\/2019-ar-threats-report-508.pdf. Published 2019. Accessed July 21, 2020."},{"key":"S0899823X20003487_ref15","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.056945-0"},{"key":"S0899823X20003487_ref10","doi-asserted-by":"publisher","DOI":"10.1086\/667743"},{"key":"S0899823X20003487_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.174"},{"key":"S0899823X20003487_ref8","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.296"},{"key":"S0899823X20003487_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2003.08.005"},{"key":"S0899823X20003487_ref6","doi-asserted-by":"publisher","DOI":"10.1086\/599070"},{"key":"S0899823X20003487_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2019.11.009"},{"key":"S0899823X20003487_ref14","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-015-0097-x"},{"key":"S0899823X20003487_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2019.11.021"},{"key":"S0899823X20003487_ref5","first-page":"1184","article-title":"Impact of long-term care facility residence on the antibiotic resistance of urinary tract Escherichia coli and Klebsiella","volume":"72","author":"Rosello","year":"2017","journal-title":"J Antimicrob Chemother"},{"key":"S0899823X20003487_ref16","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.112"},{"key":"S0899823X20003487_ref21","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15518"},{"key":"S0899823X20003487_ref23","unstructured":"23. Reform of requirements for long-term care facilities: final rule (CMS-3260-P). Centers for Medicare & Medicaid Services website. https:\/\/www.federalregister.gov\/documents\/2016\/10\/04\/2016-23503\/medicare-and-medicaid-programs-reform-of-requirements-forlong-term-care-facilties. Published 2016. Accessed August 20, 2019."},{"key":"S0899823X20003487_ref1","unstructured":"1. The core elements of antibiotic stewardship for nursing homes. Centers for Disease Control and Prevention website. http:\/\/www.cdc.gov\/longtermcare\/index.html Published 2015. Accessed May 6, 2019."},{"key":"S0899823X20003487_ref7","doi-asserted-by":"publisher","DOI":"10.1086\/647981"},{"key":"S0899823X20003487_ref20","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy035"},{"key":"S0899823X20003487_ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-007-6180-2"},{"key":"S0899823X20003487_ref12","unstructured":"12. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing: 24th informational supplement. Wayne, PA: CLSI; 2014:M100-S24."},{"key":"S0899823X20003487_ref25","unstructured":"25. The White House (US) national strategy for combating antibiotic-resistant bacteria. White House website. https:\/\/www.whitehouse.gov\/sites\/default\/files\/docs\/carb_national_strategy.pdf. Published 2014. Accessed February 10, 2020."},{"key":"S0899823X20003487_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky488"},{"key":"S0899823X20003487_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03570.x"},{"key":"S0899823X20003487_ref11","unstructured":"11. NSHN Long-term care facility component urinary tract infection. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/nhsn\/pdfs\/ltc\/ltcf-uti-protocol-current.pdf. Updated January 2019. Accessed January 29, 2019."}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X20003487","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T08:12:13Z","timestamp":1609402333000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X20003487\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,12]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["S0899823X20003487"],"URL":"https:\/\/doi.org\/10.1017\/ice.2020.348","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,12]]},"assertion":[{"value":"\u00a9 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}