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This Week in JAMA
February 10, 1999

This Week in JAMA

JAMA. 1999;281(6):489. doi:10.1001/jama.281.6.489

In an investigation of an outbreak of infections caused by ceftazidime sodium–resistant Escherichia coli and Klebsiella pneumoniae, Wiener and coworkersArticle found that 35 of 55 hospitalized patients who were colonized or infected with these isolates had been admitted from nursing homes. Risk factors for colonization with these resistant bacteria among nursing home patients included presence of a gastrostomy tube and prior use of ciprofloxacin or trimethoprim-sulfamethoxazole. All resistant isolates were found to have plasmids encoding a common ceftazidime-hydrolyzing β-lactamase. In an editorial, Fierer and GuineyArticle explain how transfer of resistance plasmids among bacterial species spreads antibiotic resistance even in the absence of antibiotic-mediated selection.