2001 OPEN FORUM Abstracts
Multi-Drug Resistant Streptoccocus Pneumoniae in a Subacute Facility
Donald Janner,MD , D Regitor; Kathy Comer, MSN, FNP; Helen Newsom, BSN, NP; Daved vanStralen Md; Ravindra Rao, MD; Doug Padgett, BS, NHA. Totally Kids® SpecialtyHealthcare, Loma Linda, CA; Loma Linda University Medical Center, Loma Linda,CA.
Purpose: Multiple drug resistancehas become a problem in long-term care facilities. We describe multiple drugresistance in Streptoccocus pneumoniae from tracheal aspirates at a long-termfacility.
Methods: Patients are froma 50-bed, freestanding, pediatric subacute facility for tracheostomy dependentpatients (ventilator and non-ventilator dependent). Tracheal cultures obtainedfor body temperature greater than 38.3°C, change in respiratory status orchange in secretions (thick, green). Minimal inhibitory concentrations (MIC)were determined by e-test for penicillin and deflriaxone.
Results: 221 cultures, 25(11%) were positive for Streptoccocus from 17 patients.
|Antiobiotic||Resistance(MIC in mcg)||Specimensn (%)|
Data shown are mean ±SD. Numbers in parenthesis indicate range.
Conclusion: The HHs reportedhere failed to maintain the airway opeing T at the set point or T varied greatlyunder pediatric ventilatory settings with a low continuous flow.ClinicalImplications: Multiple antibiotic resistance of Streptoccocus pneumoniaecan occur in long-term care facilities. MIC may help guide therapy.