Low level of antimicrobial resistance in Escherichia coli among Swedish nursing home residents

Scand J Infect Dis. 2013 Feb;45(2):117-23. doi: 10.3109/00365548.2012.717232. Epub 2012 Sep 19.


Background: Screening for bacterial colonization and antimicrobial resistance (AMR) among a defined population could aid in the identification of at-risk populations and provide targets for antibiotic stewardship and infection control programmes.

Methods: Two hundred and sixty-eight participants at 11 Swedish nursing homes underwent serial screening for colonization with Escherichia coli between March 2008 and September 2010. Seventy-two of the 268 participants (27%) were male. The median age was 85 y. Samples were collected from urine, the rectal mucosa, the groin, and active skin lesions.

Results: Two hundred and nine of 268 participants (78%) were colonized with E. coli at any body site/fluid. The specific colonization rates were 81% (rectum), 48% (urine), 30% (groin), 59% (unknown), and 13% (skin lesion). An antibiotic-resistant E. coli isolate was identified in 18% of all participants regardless of colonization status; all together, 87 resistant isolates were detected. Only 1 participant carried isolates with resistance to third-generation cephalosporins (cefotaxime and ceftazidime).

Conclusions: The presence of resistance was generally low, and the greater part of the resistant cases was connected with 3 common antibiotics: ampicillin, trimethoprim/sulfamethoxazole, and ciprofloxacin. In spite of generally increasing resistance against third-generation cephalosporins in E. coli in Sweden, this study does not implicate residence at a Swedish nursing home as a risk factor for the acquisition of expressed cephalosporin resistance.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Carrier State / epidemiology
  • Carrier State / microbiology
  • Drug Resistance, Bacterial
  • Escherichia coli / drug effects*
  • Escherichia coli / isolation & purification
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / microbiology*
  • Escherichia coli Infections / urine
  • Female
  • Groin / microbiology
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Nursing Homes / statistics & numerical data*
  • Prevalence
  • Rectum / microbiology
  • Skin / microbiology
  • Sweden / epidemiology
  • Urine / microbiology


  • Anti-Bacterial Agents