Abstract
Long-term care facilities are comprised of a heterogeneous group of institutions caring for residential patients over prolonged periods of time. Included as long-term care facilities in this review are private and Veterans' Affairs (VA) nursing homes, rehabilitation centers, institutions for the developmentally disabled, and hospital wards for both long-term and intermediate care. Patients in long-term care facilities incur bacterial infections at a prevalence of 10% to 16%. These infections usually are caused by common bacterial pathogens that invade the compromised host residing within a complex physical environment. The high prevalence of institutional infections leads, in turn, to the need for multiple courses of antimicrobials or for hospitalization. This process selects strains more resistant to antibiotics, which are then available for repeated dispersal in the long-term care facility.
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