Is Nursing Home Specific Antibiogram Necessary for All Nursing Homes?
Methods: Using a retrospective study design, we collected susceptibility results of all positive urine cultures sent to Vidant Medical Center microbiology laboratory from 4 closely located nursing homes during the calendar year of 2012. Positive culture results lacking definitive identification or antibiotic susceptibility of microorganisms were excluded. Susceptibility results for commonly used antibiotics were compared for statistically significant differences in the most commonly identified organism among 4 nursing homes using Fisher’s exact test.
Results: Escherichia coli was the most common microorganism from urine cultures with 99 total isolates (21, 23, 19 and 36 from nursing homes A, B, C and D, respectively). When comparing sensitivities of Escherichia coli in nursing homes A, B, C and D, 86%, 78%, 63% and 81% of the isolates were sensitive to trimethoprim-sulfamethoxazole, respectively (p=0.35); 76%, 78%, 58% and 61% to ciprofloxacin (p=0.33), 90%, 87%, 89% and 81% to cefazolin (p=0.69); 95%, 96%, 95% and 100% to nitrofurantoin (p=0.68). The only significant difference was in the sensitivity of ampicillin (62%, 39%, 11% and 44%, p=0.01). Other common organisms included Klebsiella pneumoniae (n=38), Enterococcus species (n=36), Proteus mirabilis (n= 34), and Pseudomonas aeruginosa (n=22). The number of organisms was too small for statistical analysis for all of these isolates.
Conclusion:We have demonstrated that antimicrobial susceptibilities were similar for most antibiotics in closely located nursing homes. Antimicrobial stewardship programs can consider developing regional nursing home antibiograms if multiple nursing homes are located in close proximity. This practice can be particularly helpful when developing antibiograms for smaller size nursing homes.
T. Lee, None
M. S. Ashraf, None
J. Christie, None
X. Fang, None