Abstract
This study aimed to develop appropriate measures against drug-resistant bacteria for elderly people living in long-term care facilities. The stool samples of facilities A-C were analyzed via a survey on extended-spectrum beta-lactamase (ESBL) -producing bacteria carriage. Factors related to carriage, user characteristics, and facility characteristics were also analyzed. The results showed that the detection rate of ESBL-producing bacteria was significantly higher in the antibacterial drug administration group (detection rate ratio of 12.71 [95%CI: 1.33-121.53]), indicating a relationship between ESBL-producing bacteria carriage and antibiotics usage history. Moreover, the detection rate was highest (36.7%) in elderly living in unit-type (private room) facility (facility B) with the lowest degree of care. The detection rate was lowest (5.9%) in the conventional (multi-bed room type) facility (facility C) with a high level of nursing care. The key difference between the two facilities was that some users were prescribed antibiotics daily in facility B while no antibiotics were prescribed at all in facility C. It was once thought that nursing homes for the elderly play a major role in spreading drug-resistant bacteria. However, the results of this study suggest that the risk of drug-resistant bacteria carriage varies greatly depending on the frequency of antibiotics prescription.
