Long-term care facilities as sources of antibiotic-resistant nosocomial pathogens

Long-term care facilities house individuals that have usually been transferred from acute-care institutions. For this reason, carriage of methicillin-resistant Staphylococcus aureus (MRSA), resistant Gram-negative bacilli and vancomycin-resistant enterococci (VRE) is relatively frequent. As these patients are readmitted to acute-care institutions, they reintroduce these organisms into those settings. It is notable that studies of these resistant organisms in long-term care facilities demonstrate little transfer between patients. Transmission of these bacteria and the development of infection in nursing homes are both uncommon events. Resources are best devoted to infection-control basics than to isolation of patients colonized or infected with these organisms.