JAC-Antimicrobial Resistance最新文献

{"title":"AMRrounds: presumed mechanisms of resistance in a case of XDR <i>Klebsiella pneumoniae</i> empyema.","authors":"Michael Casias, Madison Salam","doi":"10.1093/jacamr/dlaf019","DOIUrl":"10.1093/jacamr/dlaf019","url":null,"abstract":"","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlaf019"},"PeriodicalIF":3.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Host-response testing with MeMed BV in community-acquired pneumonia: an economic evaluation from the UK NHS perspective.","authors":"Emily Gregg, Sara Graziadio, William Green, Daniela Afonso, Monica Garrett, Karina Watts, Deborah Watkins, Enitan D Carrol, Jonathan Cooke, Tim Felton","doi":"10.1093/jacamr/dlaf016","DOIUrl":"10.1093/jacamr/dlaf016","url":null,"abstract":"<p><strong>Background: </strong>Community-acquired pneumonia (CAP) remains a leading cause of hospital admissions and mortality. A novel host-response test, MeMed BV (MMBV), has been developed for discriminating between bacterial and viral infection that could improve the clinical management of CAP.</p><p><strong>Objectives: </strong>To evaluate the cost-effectiveness of using MMBV to guide antibiotic decisions in the clinical management of CAP in the UK.</p><p><strong>Methods: </strong>An economic model was developed to understand the incremental cost per person associated with the implementation of MMBV from the UK NHS perspective. A qualitative care pathway analysis was performed to inform the standard of care (SOC) and SOC plus MMBV (SOC + MMBV) clinical pathways captured in the model.</p><p><strong>Results: </strong>In the base case analysis, the SOC + MMBV strategy for a hypothetical cohort of 1000 patients (adults and children modelled independently) presenting to the emergency department with suspected CAP was estimated to provide total cost savings of £134 018 and £105 750 for adults and children, respectively. Cost savings were associated with reductions in total antibiotic treatment, the number of patients receiving additional diagnostic tests, and hospital admissions. Deterministic sensitivity analysis revealed that the specificity of SOC + MMBV and sensitivity of the SOC were primary drivers of the cost model for adults, whereas the specificity of SOC and SOC + MMBV were primary drivers for paediatrics.</p><p><strong>Conclusions: </strong>Overall, the model predicts that the introduction of SOC + MMBV has the potential to be cost-saving and promote antimicrobial stewardship for both adult and paediatric CAP patients.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlaf016"},"PeriodicalIF":3.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the impact of using a patient counselling prompt-the TARGET antibiotic checklist in England's community pharmacies.","authors":"Sejal Parekh, Lingqian Xu, Catherine V Hayes, Kieran Hand, Diane Ashiru-Oredope, Donna M Lecky","doi":"10.1093/jacamr/dlaf018","DOIUrl":"10.1093/jacamr/dlaf018","url":null,"abstract":"<p><strong>Background: </strong>An estimated 1.27 million deaths globally were caused by antibiotic-resistant infections in 2019. Outcome 2 of the UK national action plan to combat antimicrobial resistance is improved public engagement and education with a specific and measurable target.</p><p><strong>Objectives: </strong>To evaluate and compare 2 years of the use of the TARGET antibiotic checklist in England's community pharmacies via the Pharmacy Quality Scheme (PQS).</p><p><strong>Methods: </strong>The use of the TARGET antibiotic checklist was incentivized in the PQS for 2021-22 and 2023-24 for patients presenting with antibiotic prescription in community pharmacy during a 4 week period each year.</p><p><strong>Results: </strong>A total of 406 333 patients were counselled using the TARGET antibiotic checklist, with 10 081 community pharmacies participating in either year and 6209 community pharmacies participating in both years. The most common indications for both years were chest and urinary tract infections with amoxicillin and nitrofurantoin, respectively, being the most frequently prescribed antibiotics for both PQS years examined. A total of 27 898 influenza vaccinations were delivered by community pharmacies prompted by discussions whilst using the antibiotic checklist. In addition, 140 473 patient information leaflets were provided to patients to improve knowledge about their condition and treatment and to support future self-care.</p><p><strong>Discussion: </strong>The investment in training and resources for community pharmacies through the PQS has provided opportunities for strengthening antimicrobial stewardship by equipping them with the tools to improve patient knowledge of antibiotic use, symptom resolution and antimicrobial resistance using the TARGET antibiotic checklist, as well as other resources from the TARGET Antibiotics Toolkit.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlaf018"},"PeriodicalIF":3.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic resistance in the Middle East and Southern Asia: a systematic review and meta-analysis.","authors":"Rachel Mathu, Elizabeth Diago-Navarro, Emily Lynch, Marie-Amélie Degail, Janet Ousley, Rupa Kanapathipillai, Justine Michel, Marc Gastellu-Etchegorry, Nada Malou","doi":"10.1093/jacamr/dlaf010","DOIUrl":"10.1093/jacamr/dlaf010","url":null,"abstract":"<p><strong>Introduction: </strong>Despite global surveillance efforts, antibiotic resistance (ABR) is difficult to address in low- and middle-income countries (LMICs). In the absence of country-wide ABR surveillance data, peer-reviewed literature is the next most significant source of publicly available ABR data. Médecins Sans Frontières conducted this review in hopes of using the pooled findings to inform treatment choices in the studied countries where sufficient local ABR data are unavailable.</p><p><strong>Methods: </strong>A systematic literature review reporting ABR rates for six infection sites in nine countries in the Middle East and Southern Asia was conducted. PubMed was used to identify literature published between January 2012 and August 2022. A meta-analysis of the included studies (<i>n</i> = 694) was conducted, of which 224 are reviewed in this paper. The JBI critical appraisal tool was used to evaluate risk of bias for included studies.</p><p><strong>Results: </strong>This paper focuses on sepsis, burns and wound infections, specifically, with the largest number of papers describing data from Iran, Türkiye and Pakistan. High (>30%) resistance to recommended first-line antibiotics was found. Gram-negative resistance to ceftriaxone, aminoglycosides and carbapenems was high in burn-related infections; colistin resistance among <i>Klebsiella pneumoniae</i> isolates in Pakistan was alarmingly high (81%).</p><p><strong>Conclusions: </strong>High-quality data on ABR in LMIC settings remain difficult to obtain. While peer-reviewed literature is a source of publicly available ABR data, it is of inconsistent quality; the field also lacks agreed reporting standards, limiting the capacity to pool findings. Nonetheless, high resistance to first-line antibiotics underscores the need for improved localized surveillance and stewardship.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlaf010"},"PeriodicalIF":3.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma concentration of azithromycin and correlation with clinical outcomes in patients with enteric fever.","authors":"Rini Bandyopadhyay, Sumith K Mathew, Balaji Veeraraghavan, Prasanna Samuel, Jacob Backiyaraj, Sowmya Sathyendra, Priscilla Rupali","doi":"10.1093/jacamr/dlaf015","DOIUrl":"10.1093/jacamr/dlaf015","url":null,"abstract":"<p><strong>Background: </strong>Azithromycin is the only oral option available for XDR enteric fever. Studies correlating azithromycin levels with treatment success are rare.</p><p><strong>Methods: </strong>Serum azithromycin levels after administration of a once-daily 20 mg/kg dose for 7 days were measured in a single-centre prospective cohort of 25 consecutive adults with blood culture-positive enteric fever. Five blood samples were collected on Day 2 after starting azithromycin, i.e. 30 min before dosing (trough), and 2, 5, 12 and 24 h after dosing. The MIC was determined for all isolates and azithromycin plasma concentration was determined using LC-MS. Clinical and microbiological outcomes were documented.</p><p><strong>Results: </strong><i>Salmonella enterica</i> serovar Typhi accounted for 92% (<i>n</i> = 23) and <i>Salmonella enterica</i> serovar Paratyphi 8% (<i>n</i> = 2). Ten (40%) patients received IV azithromycin, and the rest received oral therapy. The median (IQR, range) MIC for azithromycin was 4 (4-6, 3-12) mg/L. Mean azithromycin plasma concentration ranges were: trough, 0.24 ± 0.19 mg/L; 2 h, 1.24 ± 0.98 mg/L; 5 h, 0.64 ± 0.51 mg/L; 12 h, 0.31 ± 0.16 mg/L; and 24 h, 0.37 ± 0.30 mg/L. The <i>C</i> _max/MIC and AUC/MIC for azithromycin were 0.29 ± 0.22 and 2.64 ± 1.64, respectively. The median (IQR, range) fever clearance time was 3 (2-3, 2-5) days and the length of hospital stay was 7 (5.5-12, 4-16) days. There was no clinical or microbiological failure, relapse or mortality.</p><p><strong>Conclusions: </strong>Azithromycin was effective in treatment of enteric fever, despite low extracellular azithromycin plasma levels.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlaf015"},"PeriodicalIF":3.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive analysis of antimicrobial resistance of clinical <i>emm</i>89 <i>Streptococcus pyogenes</i> in Japan.","authors":"Weichen Gong, Masayuki Ono, Masaya Yamaguchi, Daisuke Motooka, Yujiro Hirose, Kotaro Higashi, Momoko Kobayashi, Eri Ikeda, Tomoko Sumitomo, Rumi Okuno, Takahiro Yamaguchi, Ryuji Kawahara, Hitoshi Otsuka, Noriko Nakanishi, Yu Kazawa, Chikara Nakagawa, Ryo Yamaguchi, Hiroo Sakai, Yuko Matsumoto, Tadayoshi Ikebe, Shigetada Kawabata","doi":"10.1093/jacamr/dlaf017","DOIUrl":"10.1093/jacamr/dlaf017","url":null,"abstract":"<p><strong>Objectives: </strong><i>Streptococcus pyogenes</i> is involved in a wide range of diseases, including pharyngitis and life-threatening invasive infections. Increasing prevalence of antimicrobial resistance (AMR) has been reported worldwide in various bacteria, limiting the use of antibiotics in infection cases. The present study investigated the AMR of most prevalent <i>S. pyogenes emm</i> types, including <i>emm</i>89 strains in Japan.</p><p><strong>Methods: </strong>A total of 368 previously identified <i>S. pyogenes</i> isolates (311 <i>emm</i>89 strains and 57 of other <i>emm</i> types), which were previously isolated from patients with invasive and non-invasive infections throughout Japan, were used in the analyses. The minimum inhibitory concentrations of seven antibiotics, including penicillin-G, azithromycin (AZM) and clindamycin, were determined, and whole-genome sequences of AMR-associated genes were screened.</p><p><strong>Results: </strong>We identified 47 resistant strains, of which 91.49% (43/47) were resistant to AZM and/or clindamycin. A strong correlation was observed between non-invasive phenotypes and AMR. Whole-genome analysis indicated the wide distribution of three AMR-related genes, <i>ermT</i>, <i>folP</i> and <i>lmrP</i>, among the <i>emm</i>89 strains. Additionally, <i>tetO</i> was detected in tetracycline-resistance and <i>soxS</i> and <i>mel</i> was detected in chloramphenicol-resistance only in <i>emm</i>4 strains.</p><p><strong>Conclusions: </strong>The high prevalence of <i>S. pyogenes</i> resistance to AZM and/or clindamycin poses a threat to public health in Japan; thus, the development of next-generation antimicrobial therapies is imperative.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlaf017"},"PeriodicalIF":3.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into MLS_B resistance in invasive group A streptococci in West Virginia, USA.","authors":"Lillie M Powell, Soo Jeon Choi, P Rocco LaSala, Slawomir Lukomski","doi":"10.1093/jacamr/dlaf021","DOIUrl":"10.1093/jacamr/dlaf021","url":null,"abstract":"","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlaf021"},"PeriodicalIF":3.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and antimicrobial susceptibility of bacteria causing acute otitis media in children at Vietnam National Children's Hospital: a cross-sectional study.","authors":"Hồng Điệp Đỗ, Minh Điển Trần, Tuyết Xương Nguyễn, Thị Bích Thủy Phùng, Thị Bích Ngọc Hoàng, Thị Lan Liên Phạm, Minh Nguyen, Elena DeAngelis, Hữu Tiệp Thân, Khắc Trưởng Nguyễn, Adriana Guzman-Holst","doi":"10.1093/jacamr/dlaf006","DOIUrl":"10.1093/jacamr/dlaf006","url":null,"abstract":"<p><strong>Background: </strong>Acute otitis media (AOM) is a leading cause of healthcare visits, antibiotic prescription and complications in children aged under 5 years. Following the introduction of pneumococcal conjugate vaccines (PCVs), non-typeable <i>Haemophilus influenzae</i> (NTHi) has become the most common causative agent for AOM, followed by <i>Streptococcus pneumoniae</i> and <i>Moraxella catarrhalis</i>. PCVs are not yet included in the National Immunization Program in Vietnam.</p><p><strong>Objectives: </strong>To determine the frequency and characteristics of the pathogens related to AOM in Vietnam in children ≤5 years old.</p><p><strong>Methods: </strong>This was a cross-sectional study performed at the Vietnam National Children's Hospital from October 2021 to December 2023 in children ≤5 years old diagnosed with acute suppurative otitis media. Clinical features of the children were described. Pathogens of interest were identified by culture or real-time PCR (rtPCR). The antibiotic susceptibility profiles of <i>H. influenzae</i> and <i>S. pneumoniae</i> isolates were determined.</p><p><strong>Results: </strong>In total, 482 children ≤5 years old were included, of which 70.8% were ≤2 years old and 61% had an history of AOM. The most frequent bacteria isolated were <i>H. influenzae</i> (52.1%, 99.6% of which were NTHi) and <i>S. pneumoniae</i> (41.1%). Most <i>S. pneumoniae</i> isolates were resistant to azithromycin, clarithromycin and cefuroxime. Most <i>H. influenzae</i> isolates were resistant to amoxicillin, cefixime, cefuroxime, azithromycin and clarithromycin.</p><p><strong>Conclusions: </strong>The pathogens most frequently associated with AOM in this study were in line with previous findings. Many isolates were resistant to commonly given oral antibiotics. These results can inform decision-making on AOM prevention and treatment strategies in Vietnam.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlaf006"},"PeriodicalIF":3.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An audit of antibiotic prescriptions: an antimicrobial stewardship pre-implementation study at a tertiary care public hospital.","authors":"Jowhara Cassim, Sabiha Y Essack, Sarentha Chetty","doi":"10.1093/jacamr/dlae219","DOIUrl":"10.1093/jacamr/dlae219","url":null,"abstract":"<p><strong>Objective: </strong>To audit the prescribing of antibiotics at a tertiary-level public hospital, in preparation for the implementation of an antimicrobial stewardship programme.</p><p><strong>Methods: </strong>A retrospective audit of antibiotic prescriptions for the period April 2020 to June 2020 was conducted to ascertain appropriate antibiotic prescribing based on a set of process measures, which included whether cultures were taken before the initiation of empirical antibiotics, the duration of antibiotic therapy, de-escalation to a narrower spectrum antibiotic, the concurrent use of four or more antibiotics, documented indication for antibiotic use, and parenteral to oral conversion. Statistics were calculated using Stata (Version 17).</p><p><strong>Results: </strong>A total of 380 patient medical charts were reviewed. It was noted that there were no standalone antibiotic charts, and antibiotics were prescribed alongside other medication in one prescription record. There was non-compliance to one or more of the process measures in two-thirds of antibiotic prescriptions audited. Excessive duration of therapy was evident in 3.16% (12) prescriptions. There were 18 (4.74%) instances in which de-escalation to a narrower spectrum antibiotic based on susceptibility results did not occur. Only a small proportion of patients were switched from parenteral to oral antibiotics (<i>n</i> = 12, 3.16%). Some of the additional findings included redundant antibiotic coverage (<i>n</i> = 137, 36.05%) and prescription of an antibiotic that did not align with the susceptibility results (<i>n</i> = 98, 25.79%).</p><p><strong>Conclusions: </strong>Inappropriate antibiotic prescribing did occur in some cases. The results from this pre-implementation study highlight the importance of introducing antimicrobial stewardship interventions with process and outcome measures.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlae219"},"PeriodicalIF":3.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-year monitorization of the gut colonization by multidrug resistant bacteria in elderly of a single long-term care facility.","authors":"Cristina Colmenarejo, Concepción Rodríguez-Jiménez, Francisco Javier Navarro, Ana Belén Mateo, Eva María Pellejero, Rosa María Belda-Moreno, Roberto Ureña-Méndez, Raúl Pérez-Serrano, Soledad Illescas, José Ramón Muñoz-Rodríguez, Rosa Del Campo","doi":"10.1093/jacamr/dlaf008","DOIUrl":"10.1093/jacamr/dlaf008","url":null,"abstract":"<p><strong>Objective: </strong>To monitor the gut colonization by multidrug resistant (MDR) bacteria in residents of a single long-term care facility (LTCF) in relation to their clinical evolution, antibiotic consumption and mortality risk.</p><p><strong>Methods: </strong>In a total of 187 voluntarily enrolled residents, five rectal swabs samples were recovered over 1 year. Selective media were used to isolate MDR bacteria. Clinical data related to infections, antibiotic consumption and mortality were recovered. Mortality risk among residents who were MDR colonized and non-colonized was compared by Kaplan-Meier curves.</p><p><strong>Results: </strong>Globally, 25% of residents have gut colonization by ESBL-producing <i>Escherichia coli</i> with a lack of other pathogens such as <i>Acinetobacter baumannii</i> or <i>Clostridioides difficile</i>. Monitoring of ESBL-producing <i>E. coli</i> colonization for 1 year allowed to us to establish three categories among residents: 48.6% never colonized, 15.5% had a persistent colonization, and the remaining 35.8% presented intermittent colonization. The rates of mortality, infections and antibiotic exposure were comparable among ESBL-producing <i>E. coli</i> colonized and non-colonized residents, except for the intermittent colonization group in which a higher and statistically significant mortality rate was observed. As expected, urinary and respiratory tract infections were the most prevalent infectious pathologies in the LTCF, with amoxicillin/clavulanate and fluoroquinolones being the most prescribed antibiotics. A high percentage of ESBL-producing <i>E. coli</i> (28%), and fluoroquinolone resistance were detected in clinical samples.</p><p><strong>Conclusions: </strong>The monitoring of gut colonization by MDR microorganisms in a single LTCF for 1 year demonstrated the predominance of ESBL-producing <i>E. coli</i>. Almost half of the residents were resistant to its colonization, whereas in 15.5% of them gut colonization was stable. Incidence of infectious episodes and antibiotic exposure were comparable between colonized and non-colonized subjects, but the group with the highest risk of mortality was that with intermittent colonization by ESBL-producing <i>E. coli</i>.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlaf008"},"PeriodicalIF":3.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}