{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T22:04:09Z","timestamp":1762898649401},"reference-count":36,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":1523,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:sec id=\"S0195941700029659_abs1\"><jats:title>Background and Objective.<\/jats:title><jats:p>An improved understanding of the transmission dynamics of multidrug-resistant (MDR) gram-negative bacteria and the mechanism of acquisition in long-term care facilities (LTCFs) could aid in the development of prevention strategies specific to LTCFs. We thus investigated the incidence of acquisition of these pathogens among an LTCF population.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700029659_abs2\"><jats:title>Design.<\/jats:title><jats:p>Prospective cohort study.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700029659_abs3\"><jats:title>Setting.<\/jats:title><jats:p>Three separate wards at a 600-bed LTCF in metropolitan Boston, Massachusetts, during the period October 31, 2006, through October 22, 2007.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700029659_abs4\"><jats:title>Participants.<\/jats:title><jats:p>One hundred seventy-two LTCF residents.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700029659_abs5\"><jats:title>Methods.<\/jats:title><jats:p>A series of rectal samples were cultured to determine acquisition of MDR gram-negative bacteria, defined as absence of MDR gram-negative bacterial colonization at baseline and de novo recovery of MDR gram-negative bacteria from a follow-up culture. Molecular typing was performed to identify genetically linked strains. A nested matched case-control study was performed to identify risk factors associated with acquisition.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700029659_abs6\"><jats:title>Results.<\/jats:title><jats:p>Among 135 residents for whom at least 1 follow-up culture was performed, 52 (39%) acquired at least 1 MDR gram-negative organism during the study period. Thirty-two residents (62%) had not been colonized at baseline and had acquired at least 1 MDR gram-negative species at follow-up culture, and 20 residents (38%) were colonized at baseline and had acquired at least I MDR gram-negative species at follow-up culture. The most common coresistance pattern was resistance to extended-spectrum penicillins, ciprofloxacin, and gentamicin (57 isolates [42.5%]). Genetically related strains of MDR gram-negative bacteria were identified among multiple residents and between roommates. On conditional logistic regression analysis, antibiotic exposure during the study period was significantly associated with acquisition of MDR gram-negative bacteria (odds ratio, 5.6 [95% confidence interval, 1.1-28.7];<jats:italic>P<\/jats:italic>= .04).<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700029659_abs7\"><jats:title>Conclusions.<\/jats:title><jats:p>Acquisition of MDR gram-negative bacteria occurred frequently through resident-to-resident transmission. Existing infection control interventions need to be reevaluated.<\/jats:p><\/jats:sec>","DOI":"10.1086\/656590","type":"journal-article","created":{"date-parts":[[2010,10,5]],"date-time":"2010-10-05T14:18:24Z","timestamp":1286288304000},"page":"1148-1153","source":"Crossref","is-referenced-by-count":59,"title":["Acquisition of Multidrug-Resistant Gram-Negative Bacteria: Incidence and Risk Factors within a Long-Term Care Population"],"prefix":"10.1017","volume":"31","author":[{"given":"Erin","family":"O'Fallon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Kandell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Schreiber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika M. 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