Fluoroquinolone-resistant Escherichia coli in the long-term care setting

BACKGROUND: Prior studies have found fluoroquinolone exposure to be a risk factor for infection with fluoroquinolone- resistant gram- negative rods in the acute care setting. However, risk factors may be different in the long- term care setting. METHODS: A case- control study design was used to determine whether fluoroquinolone exposure is a risk factor for fluoroquinolone- resistant Escherichia coli urinary tract infections in a long- term care center. Cases had fluoroquinolone- resistant E. coli urinary tract infections; 4 controls were selected for each case. RESULTS: Thirty- three case patients were eligible; 132 controls were then selected. In the multivariable analysis, fluoroquinolone- resistant E. coli urinary tract infection was more common with prior fluoroquinolone use ( odds ratio 21.8, 95% confidence interval, 3.7- 127.1). CONCLUSIONS: Prior fluoroquinolone use is a strong risk factor for fluoroquinolone- resistant E. coli urinary tract infection in the long- term care setting. Further studies are needed to examine the effect of interventions to decrease fluoroquinolone- resistant infections in the long- term care setting, including studying the effect of decreasing fluoroquinolone use. (c) 2006 Elsevier Inc. All rights reserved.