Development of an antibiogram in a long-term care facility.

OBJECTIVE: To create an antibiogram-a profile of an organism's susceptibility/resistance to a panel of antibiotics- for a long-term care facility to assess the prevalence of resistance of bacteria present at the facility. DESIGN: Retrospective analysis of culture and sensitivity data from July 1, 2009, through June 30, 2010. SETTING: A long-term care facility in Huntsville, Alabama. PATIENTS AND PARTICIPANTS: Residents of the long-term care facility that had one or more culture and sensitivity test performed. MAIN OUTCOME MEASURE: Susceptibility of bacteria to each antimicrobial tested. RESULTS: Results were compiled and reported according to the Clinical and Laboratory Standards Institute Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data. The most commonly seen bacteria in our long-term care facility were Escherichia coli, Staphylococcus aureus, Enterococcus faecalis, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Proteus mirabilis. Resistance rates for these bacteria were high and included the presence of methicillinresistant S. aureus and extended-spectrum beta-lactamase-producing bacteria. CONCLUSION: Resistance rates were high among all organisms reported. This poses a serious threat to the health care team's ability to effectively treat residents of this facility. Development of an antibiogram to assist physicians in antimicrobial selection will be beneficial in helping evaluate trends in drug resistance to current available treatments. Implementing clinical pathways for empiric treatment of infections could improve the ability to provide consistent treatment for all residents in the facility.