D.F. Gilpin, PhD, Research Fellow, School of Pharmacy, Queen’s University, Belfast, Northern Ireland.
M.M. Tunney, PhD, Senior Lecturer, School of Pharmacy, Queen’s University, Belfast, Northern Ireland.
N. Baldwin, PhD, Research Fellow, School of Pharmacy, Queen’s University, Belfast, Northern Ireland.
C.M. Hughes, PhD, Professor, School of Pharmacy, Queen’s University, Belfast, Northern Ireland.

Methicillin-resistant Staphlyococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) are responsible for substantial morbidity and mortality in acute care settings. Older residents in long-term care (LTC) facilities possess many of the risk factors for colonization with these antibiotic resistant bacteria, and the potential exists for both transmission, via transiently colonized staff, within LTC, and subsequent reintroduction into hospitals. Infection control policies in LTC are primarily based on those used in acute care and may not be appropriate for this unique environment. Studies to determine which infection control procedures are effective at reducing the prevalence and transmission of MRSA and VRE in LTC are required.
Key words: long-term care, MRSA, VRE, colonization, infection control.

Focus on Long-term Care Facilities

Shelly A. McNeil, MD, FRCPC, Division of Infectious Diseases, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, NS.
Lona Mody, MD, Divisions of Geriatric Medicine, Veterans Affairs Medical Center and The University of Michigan Medical School, Ann Arbor, MI, USA.
Suzanne Bradley, MD, Divisions of Geriatric Medicine and Infectious Diseases, Veterans Affairs Medical Center and The University of Michigan Medical School, Ann Arbor, MI, USA.

Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) are important causes of morbidity and mortality in hospitals, and rates of MRSA and VRE in long-term care facilities (LTCF) have increased. However, the majority of residents in LTCF are asymptomatically colonized and the risk of infection with MRSA or VRE in this setting is low. Extension of stringent infection control practices required to control the spread of MRSA and VRE in acute care hospitals is not warranted in the LTCF setting. Patients known to be colonized with MRSA or VRE should not be refused admission to a LTCF and, in the absence of symptomatic infection, measures beyond routine standard precautions are not necessary.