{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:20:27Z","timestamp":1785410427400,"version":"3.56.0"},"reference-count":13,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Canadian Government | Canadian Institutes of Health Research","award":["496215"],"award-info":[{"award-number":["496215"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2026,6,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Antibiograms are challenging to construct in long-term care (LTC) homes in part due to low isolate counts and limited precision. Regional-local antibiograms offer a potential solution by using partial pooling, combining data from both the home and the broader LTC population. We developed regional-local urinary antibiograms and compared this approach to standard antibiograms. This cross-sectional study included urine cultures from LTC residents across Ontario. (i) Standard syndromic combined antibiograms were created for each LTC home with \u226530 total isolates. Homes with &lt;30 isolates used the mean of susceptibility for each drug for the entire province. (ii) Partially pooled regional-local antibiograms were constructed using logistic mixed models with a random intercept for each home to ensure each LTC home could be provided a facility-specific antibiogram. We compared susceptibility and rank order of recommended antibiotics using each method. Among 627 LTC homes, 340 (54.2%) met the \u226530 isolate threshold. Regional-local methods allowed for the development of 627 LTC home-specific antibiograms. These methods narrowed susceptibility estimate ranges compared to standard methods (e.g., trimethoprim-sulfamethoxazole [TMP-SMX]: 57%\u201377% vs 37%\u201390%, respectively). A total of 119 (19.0%) homes had at least one antibiotic with over 80% susceptibility using the standard approach; only 11 (1.8%) homes met this threshold with the regional-local antibiogram. The antibiotic with the highest susceptibility varied based on methodology (amoxicillin-clavulanate for standard vs TMP-SMX for regional-local antibiogram). Regional-local antibiograms allow for the creation of facility-specific antibiograms, even among facilities with small isolate counts. This approach may provide more precise antibiotic susceptibility estimates by reducing misleading inter-facility variation.<\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>Local antibiograms can help inform empiric antibiotic treatment for long-term care residents with urinary tract infections. However, many facilities have too few isolates to create precise susceptibility estimates. A regional-local antibiogram is a novel strategy that uses a weighted approach: it prioritizes local data where available, but increasingly uses regional population-level data for homes with smaller sample sizes to improve statistical precision and reduce misleading inter-facility variation. This regional-local approach allows for the development of facility-specific antibiograms for a greater number of homes compared to traditional methods of developing antibiograms.<\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/jcm.01223-25","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T09:10:25Z","timestamp":1777281025000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Regional-local urinary antibiograms for long-term care homes: a population-wide cross-sectional study"],"prefix":"10.1128","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5467-6776","authenticated-orcid":true,"given":"Bradley J.","family":"Langford","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/025z8ah66","id-type":"ROR","asserted-by":"publisher"}],"name":"Public Health Ontario","place":["Toronto, 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Available from: https:\/\/www.ontariohealth.ca\/system\/regions"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20210215"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlab060"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2015.11.013"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.49544"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2016.03.002"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.01223-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.01223-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T13:07:48Z","timestamp":1782392868000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/jcm.01223-25"}},"subtitle":[],"editor":[{"given":"Romney M.","family":"Humphries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,6,10]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,10]]}},"alternative-id":["10.1128\/jcm.01223-25"],"URL":"https:\/\/doi.org\/10.1128\/jcm.01223-25","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,10]]},"assertion":[{"value":"2025-08-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01223-25"}}