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