104 92
ၡāāࢋ
2003 10 1 2005 9 30 2
54,468 98 224 4.110/00
79.6 94 ( 42% )
84 ( 37.5% ) 30 ( 13.4% 127
175 123 ( 70.3% ) 46 ( 26.3% ) 6 ( 3 .4% )
(Escherichia coli ) 34 ( 19.4% ) (Pseudomonas aeruginosa ) 28 ( 16% ) ( Proteus mirabilis ) 21 ( 12.0% ) ( Staphylococcus aureus ) 16 (9.1%)
( extended spectrum beta lactamase ) 35.3% ( 12/34 ) (Klebsiella pneumoniae ) 36.4% ( 4/11 )
( Methicillin resistant Staphylococcus aureus, MRSA )
ᙯᔣෟĈܜഇ᜕፟ၹ ( Long term care facility )
ੰ̰ຏߖ ( Nosocomial infection ) ຏߖ൴Ϡޘ ( Infection density )
ᇃड़ّ˙㈢ ( Extended spectrum beta lactamase, ESBL ) кࢦԩᘽّ ( Multiple drugs resistant )
݈֏
ϤٺᗁᘽซՎᄃ̳ВϠࢍ൪۞ଯજĂֹ
ၙ়ّঽ̈́ҁѐˠ˾ుѐᆧΐĄॲፂ 2006 ѐ̰
߆ొ̳Ҷ۞ྤफ़ពϯĂᄂ៉гડז 2005 ѐ 10 ͡ غͤĂ 65 ໐ͽ˯۞ҁѐˠ˾ѣ 220 ༱ĂΚᓁˠ
˾۞ 9.7% Ăពϯ઼ˠ̏ซˢ᛬̼ۤົ1Ąֶፂ
͵ࠧϠᖐҁѐ઼छ۞ؠཌྷᇾĂέ៉̏ځ ពᔙˢҁˠ઼̝ڒĄϤٺˠ˾ԣిҁ̼ăۤົ
តዏăछलඕၹԼតăઉܲග;͞ёღᒺ̈́ҁ ѐˠ͕֗ΑਕֶᏥޘᆧΐඈЯ৵Ăҁѐˠˢ ҝܜഇ᜕፟ၹ ( long-term care facilities ) ۞ᅮՐ
ּͧు႙̿2-6Ą҃ܜഇ᜕፟ၹҝϔкࠎҁ ѐˠĂጡءΑਕځពੜ̼ă࿆ѣၙ়ّঽ
۞ ય ᗟ Һ ࠪ Α ਕ ࢫ Ҳ ඈ প ّ Ă ֹ ੰ ̰ ຏ ߖ ( nosocomial infection )јࠎܜഇ᜕វր̚ᜈ хд۞યᗟĄࠎቁܲ፟ၹ᜕̰ݡኳ̈́ҝϔ۞
щБĂለ઼࡚छޝѝಶฟؕࢦෛܜഇ᜕፟ၹ
ੰ̰ຏߖ۞યᗟĂͷ၆ܜഇ᜕፟ၹຏߖѣ࠹
༊к۞͛ᚥಡӘćͅ៍઼̰ྵͻ࠹ᙯ۞ࡁտ
ྤफ़Ąࠎ˞ྋߙ᜕ந̝छੰ̰ຏߖ̝࠹ᙯ߹Җ ঽጯྤफ़Ăώࡁտଳ݈ᖀّ͞ڱᜈ 2 ѐજႾ
ീྍ፟ၹੰ̰ຏߖଐԛĂ֭አߤඕڍፋநᄃ
̶ژĂͽ೩ֻྍ፟ၹ઼̰ܜഇ᜕፟ၹੰ̰
ຏߖ̝ણ҂Ą
Մफ़ᄃ͞ڱ
˘ăՄफ़
ߙ᜕ந̝छјϲٺ 1999 ѐĂВѣ 110 ԖĂ ڇચ̰टѣ᜕ந᜕ăϠ߿ᜪăࢴᒉዳăᗁ ᒚڇચăೇઉڇચඈĄ၆෪ͽܜഇاछۻঽͻˠ
᜕நफ़۰ăҁᔙă፟ਕੜ̼ăᅅޘᘡӑ۰ă̚
ࢲăឨႼăҖજ̙ܮ۰اкĄҝϔࢋֽࠎЧ ᗁᒚ፟ၹੰޢᖼˢ̝ঽˠاкĄࡁտഇมҋ 2003ѐ 10 ͡ 1 ͟Ҍ 2005 ѐ 9 ͡ 30 ͤ͟Ăࠎഇ 2 ѐĄ၆෪ࠎٙѣˢҝ᜕ந̝छ̝ҝϔĄ
˟ă͞ڱ
ྍ፟ၹ̰ੰ̰ຏߖ۞ќ९ĂߏϤѣЪॾᙋ
۞ຏߖგט᜕நरͽજّăᜈّ̈́ր
ّĂઇ݈ᖀّؠഇႾീҝϔຏߖ۞ଐԛĄќ९۞
ؠཌྷߏֶፂ઼࡚ 2001 ѐۍ̝ܜഇ᜕፟ၹ̰
ЧొҜຏߖќ९۞ؠཌྷćຏߖొҜΒ߁کԌຏ ߖăײӛຏߖăϩቲຏߖăབࡤຏߖăҕ߹
ຏߖ̈́ீ҅ᆄ˾ຏߖ7Ąќะ۞ྤफ़ֽҋຏߖგ ט᜕நरؠഇణෛ፟ၹăྎዦঽ።ྶ ( ӣܝă
ާ෧ࡔᐂ )ă၁រވඕڍ᜕̈́ˠࣶ̝ణኘĄຏ ߖგטरЪ፟ၹ̰ੰ̰ຏߖؠཌྷ۞࣎९ྤफ़
൳ᐂٺĶ፟ၹ̰ੰ̰ຏߖྤफ़ΙķĂྤफ़Β߁ҝ ϔૄώྤफ़ăˢҝ፟ၹ͟ഇăຏߖ͟ഇăຏߖা
ې̈́ొҜăຏߖ۞ෂ̈́ԩϠ৵ୂຏྏរඕڍ
࠹ᙯПᐍЯ̄Ąٙଳะ۞ᑭវ˘ޠਖ਼ـߙᗁጯ̚
͕ઇෂঀ۞ૈዳᄃᝥؠĄֹϡ͞ڱܼ˘ਠ၁រވ
ٙଳϡ۞ૈዳ̈́ᇾ็Ϡ̼ྏរᝥؠ͞ڱ8Ą ҌٺԩϠ৵ୂຏྏរߏͽ National Committee for Clinical Laboratory Standards ( NCCLS )Ăٙטؠ
۞৽რᘜᕖڱ9Ąҝϔˢҝ᜕ந̝छ 48 ̈ॡ ޢͽ̈́ᖼੰޢ 48 ̈ॡٙயϠ۞ຏߖ࠰ᕩᛳྍ᜕
ந̝छ۞ੰ̰ຏߖĄ፟ၹ̰ຏߖ൴Ϡޘ = ( ຏ ߖˠѨ/ᓁˢҝˠ͟ᇴ )Ű 1000 Ăֹϡ EXCEL హ វઇྤफ̶़ژĄ
ඕڍ
˘ăຏߖ۞൴Ϡޘ
ࡁ տ ഇ ม ྍ ᜕ ந ̝ छ ۞ ˢ ҝ ˠ ͟ ᇴ ࠎ 54,468ĄՏ࣎͡۞πӮҝϔᇴࠎ 72 ˠĂѣ 90%
ᛳܜഇۻԖćֹ̚ϡᆄࡤგ۞ҝϔĂπӮՏ͡
ࠎ40ˠ ( 55.6% )ĂֹϡጱԌგ۰ࠎ29ˠ ( 40.3% )Ă
ဦ ˘ Ĉ ᜕ ந ̝ छ ፟ ၹ ̰ ੰ ̰ ຏ ߖ ൴ Ϡ ޘ ᔌ ๕ ဦ (Oct2003-Sept2005).
Ś u ( ຏߖޘ ) ŕ UCL ( ˯ᅧࣃ ) Ŝ u-Bar ( πӮࣃ ) œ LCL ( ˭ᅧࣃ )
ֹϡঈ̷გ۰ࠎ 25 ˠ ( 34.7% )ĄࡁտഇมĂВѣ 98Ҝҝϔ൴Ϡ 224 ˠѨ፟ၹ̰ੰ̰ຏߖć̚շ
ّ 129 ˠѨ ( 57.6% )Ẵّ 95 ˠѨ ( 42.2% )Ą ҝϔຏߖ൴Ϡޘ ( infection density ) πӮࠎ 4.110/00ĂଂՏ࣎͡۞ຏߖޘֽ࠻Ăд 2005 ѐ 7͡ 9 ͡Чѣ˘Ѩځព۞ள૱ࣃ ( ဦ˘ )Ăពϯ ѣள૱۞ຏߖன෪Ą 7 ͡൴Ϡ۞፟ၹ̰ຏߖѣ 16 ˠᛳٺײӛຏߖć̚ѣ 5 ˠᛳٺཏჸຏߖĂ
ֽܼҋТ˘ঽވĄ߹ຏԣిᑭរĂᙋ၁ 4 ˠࠎ A ݭ߹ຏĂΩ 1 ˠࠎ A ̈́ B ݭ߹ຏĄአߤ൴னѩ 5
࣎ҝϔ่̚ѣ˘ˠϏତצ߹ຏࠪࡺڦडĄགྷ࿅ຏ ߖ გ ט ˠ ࣶ ޙ ᛉ ଳ ϡ ᗓ ନ ߉ ֭ ֹ ϡ ҹ ߹ ຏ ( Tamiflu ) ޢࠪଐͽଠטĄҌٺ 9 ͡൴Ϡ۞፟
ၹ̰ຏߖѣ 8 ˠᛳٺײӛຏߖĂᛳдّ֭
ཏჸ۞ன෪ć߹ຏԣిᑭរϺ࠰ࠎౚّĄྍ፟ၹ
̰ҝϔ۞ੰ̰ຏߖ۞Ѩᇴࠎ 1-10 Ѩ̙ඈĂπӮ ࡗ 2.3 ѨĄຏߖҝϔ۞ѐ᛬ଂ 38 Ҍ 107 ໐̝มĂ πӮ 79.6 ໐Ą
˟ăຏߖొҜ۞̶Ҷ
ᓁВ 2 2 4 ˠѨ፟ၹ̰ੰ̰ຏߖొҜ۞̶Ҷ
̚Ă૱֍۞ࠎکԌຏߖ 94 ˠѨ ( 42% )Ă
Ѩࠎײӛຏߖ 84 ˠѨ ( 37.5% )Ăҕ߹ຏߖ 30 ˠѨ ( 13.4% )Ăͽ̈́ϩቲຏߖ 16 ˠѨ ( 7.1% )Ą አߤഇม֭Ϗ൴னѣབࡤຏߖ࣎९Ą
ˬăෂጯ۞̶ژ
д 224 ˠѨ፟ၹ̰ຏߖĂଵੵ่ϤᓜԖাې ҿؠ֭Ϗགྷ၁រވᙋ၁ޢĂѣ 127 ˠѨ۞ຏߖְ
І̙ҭѣᓜԖাې֭གྷ၁រވ෧ᕝቁᄮĂҫБొ
ੰ̰ຏߖ۞ 56.7% ĄᓁВ̶ᗓ 175 ঀෂ̈́ঽ
߲ĄֶຏߖొҜٙૈዳֽ۞ෂ̚Ăͽ 81 ˠѨ کԌຏߖ̶ٙᗓ 121 ෂঀࠎк(69.1%)ć
Ѩࠎҕ߹ຏߖ 3 0 ˠѨВ̶ᗓ 3 5 ෂঀ ( 20% )Ăѩ࣎ຏߖొҜෂঀВҫٙѣ̶ᗓ۞
ෂঀ 89.1% Ą̶ᗓ۞ෂঀ̚ͽࢭᜋͩౚّෂا к 123 ঀ ( 70.3% )ĂѨࠎࢭᜋͩวّෂ 46 ঀ ( 26.3% )Ăঽ߲ຏߖϺѣ 6 ঀ ( 3.4% )ć̚߹Җ
ّຏ݂ঽ߲ A ݭ 5 ঀĂ B ݭ 1 ঀĄ
ֶ૱֍ຏߖෂֽ࠻ ( ဦ˟ )Ĉ̂བ
ෂ ( Escherichia coli, E.coli )ĂΒӣѣᇃड़ّ˙
㈢ ( extended spectrum beta lactamase, ESBL ) В 34 ঀ ( 19.4% )Ăქᓘෂ ( Pseudomonas aerug-
inosa ) 28 ঀ ( 16% )Ăតԛෂ ( Proteus mirabilis ) 21ঀ ( 12.0% )ĂܛเҒཬෂ ( Staphylococcus aureus, SA ) 16 ঀ ( 9.1% )Ăབෂ ( Enterococcus ) 12ঀ ( 6.9% ) ̈́ҹϨͩෂ ( Klebsiella pneumo- niae, K-P ) 11 ঀ ( 6.3% )Ąдԩᘽّෂ͞ࢬᛳٺ
ѣᇃड़ّ˙㈢ ̂བෂ ( ESBL-E.coli ) ࠎ 35.3% ( 12/34 )Ă҃ѣᇃड़ّ˙㈢ ҹϨ
ͩෂ ( ESBL- K.P ) ࠎ 36.4% ( 4/11 )Ąٙѣ۞ܛเ ҒཬෂӮࠎԩࢃܦឣ৵ܛเҒཬෂ( Methicillin resistant Staphylococcus aureus, MRSA )Ą
ኢ
ܜഇ᜕፟ၹ۞ҝϔĂ̂кᇴߏҁѐˠĂ Ϥٺҁѐˠ۞Һࠪ˧ࢫҲăϩቲតᓠăࡤᅕഴ
͌ăঈგଵ།ਕ˧តम̈́།टٽ႖ඈЯ৵ĂГ ΐ˯ҁѐˠ˫૱ᎮଈᇴၙّঽĂౌߏጱຏߖ
۞൴Ϡத۞ࣧЯ10-14Ąѣጯ۰ܜ፟ၹຏ ߖ۞አߤᑕᜈ˘ѐͽ˯ͽᔖҺ؞༼၆ຏߖొҜ
̈́൴Ϡத۞ᇆᜩĂ͍ߏײӛຏߖдࡌྵ
ࠎ૱֍14Ąώࡁտॲፂѐഇม۞አߤ൴னĂྍ
᜕ந̝छՏѐຏߖ൴ϠޘπӮࡗ 4.10/00Ă࠹ྵ
ٺ઼γ۞͛ᚥಡӘࡗ 2.6-7.10/00֭Ϗઐ15Ąͽ Чֽ͡࠻൴Ϡޘౌࠎ 1.250/00Ҍ 13.020/00मள ໂ̂Ă߇ͽˬ࣎ᇾम̝ݡኳგந֎ޘᘱᄦຏߖ
൴Ϡޘᔌ๕ဦ൴னĂ 2005 ѐ 7 ̈́͡ 9 ͡࠰ѣ
˯ࢨ⼈ࣃ۞ଐԛĂࣧЯдٺྍ˟࣎͡ҝϔ۞ײ ӛຏߖᆧΐĂͷ 7 ͡ѣ˘Ѩ൴Ϡ߹Җّຏ݂ཏ ჸଐԛĂགྷ࿅ຏߖგט̬ˢޢĂҋ 10 ͡ϏГ൴ Ϡ࠹ТېڶĄ
᜕ந̝छ̝ຏߖొҜĂ૱֍۞ߏکԌ
ဦ˟Ĉੰ̰ຏߖෂ۞̶Ҷ.
ຏߖĂѨࠎײӛຏߖĂዶֶԔࠎБ֗ຏ ߖăீ҅ᆄಘ˾̈́ϩቲຏߖĄॲፂ઼γ࠹ᙯ۞አ ߤಡӘЧొҜຏߖ൴Ϡத൴̙֭Ⴝ࠹Т ( ܑ˘ )Ă ҭमளّ̙̂11,14,16Ą
ྍ᜕ந̝छکԌຏߖ࣎९̚Ă 75.3% ҝϔ дຏߖ݈˘ฉѣጱԌგཉĂॲፂ Mcnulty ඈˠ አߤ൴னࡻ઼ࡗ 9% ᜕ந̝छ۞ҝϔົܜഇֹϡ ጱԌგĂ҃ጱԌგ྅ཉ૱ᑕϡٺԌ୵႖̈́̈
ܮε༰۞ঽଈĂѩ྅ཉٽౄјکԌຏߖĄ 20- 30%ጱԌგཉঽଈົጱෂԌাĂ҃ 2-6% ົ
൴णࠎѣাې̝کԌຏߖĂϺѣঽଈயϠෂҕ
া17Ą Engelhart ඈˠ۞አߤ˵൴னکԌຏߖҝ ϔͽѣጱԌგཉ۞ଐԛاк12Ąੵ˞ֹϡཉ ጱԌგ̝ᇾ᜕நԫఙߏυࢋ୧ІγĂܜഇ᜕
፟ၹ۞᜕நˠࣶ˵ᑕቁ၁ෞҤጱԌგཉ۞υࢋ
ّĂͽഴ͌ጱგ྅ཉٙౄј۞ຏߖ1 0 , 1 7Ąдײӛ
ຏߖ͞ࢬĂѣ͛ᚥ۱ۆߏѪ˸த۞ຏ ߖొҜĂ҃ѩ᜕ந̝छҝϔײӛຏߖ̚ߏͽ˘
ਠຏ݂ྵࠎ૱֍Ă߇Ϗౄјᚑࢦ๋चĄҭࡁտഇ มĂд 2005 ѐ 7 ͡ѣ൴Ϡ߹Җّຏ݂ A ă B ݭ
̝ཏჸְІĂֹྍ͡ຏߖ൴Ϡத࠹၆೩Ą ҕ߹ຏߖ͞ࢬĂώѨࡁտඕڍπӮຏߖ൴Ϡ
ޘޘࠎ 0.550/00Ăѣ͛ᚥҕ߹ຏߖ۞൴Ϡ
ޘࡗࠎ 0.30/00ć˘ਠઐҲ۞ࣧЯдٺܜഇ᜕
፟ၹޝ͌ѣҕ୵ૈዳ̝၁រވĂͷਖ਼រҕ୵ᑭវ ઇૈዳϺ̙࿆18ĄϤٺѩ᜕ந̝छዐܕٺߙᗁ ጯ͕̚Ăҕ୵ૈዳྵ͞ܮĂ߇࠹၆۞ᙋ၁ѣҕ߹
ّຏߖ۞ּͧྵĄ
а໖ͽـ۞͛ᚥ˘ਠ֭Ϗྶ̶ٕژܜഇ
᜕፟ၹ૱֍۞ຏߖෂĂҭߏкࢦԩᘽّ ( mul- tiple drugs resistant )ෂౄјཏࡎ൴ְІݒజ˘
Г೩10,16,18Ąѩ᜕ந̝छ۞ੰ̰ຏߖෂϺ̙ͻ
ѣкࢦԩᘽّ۞ෂć̚ ESBL-E. coli Ă
ESBL- K.P̈́ MRSA ࠎ࿆Ą˘ਠົ͔ԩᘽ
ّෂ۞ࣧЯĂ̙γͼߏԩϠ৵۞ֹϡ̙༊Ă፟
ၹͻ߾͘న౯ͽ̈́፟ၹ᜕̚ந̍үˠࣶᇴ̙֖
19ĄϤٺѩ᜕ந̝छ۞ҝϔѣ 85% νΠֽܼҋᗁ ጯ͕̚ĂЯѩĂҝϔˢҝॡѣкࢦԩᘽّෂ
ϺΞநྋĄҌٺֱԩᘽّෂᄃ፟ၹ̰۞ੰ̰
ຏߖ̝࠹ᙯّ̪ѣޞซ˘Վᗃᄃᙋ၁Ą߇ޙᛉ ҝϔˢҝॡΞͽᎡᑭҝϔෂଐԛĂͽઇࠎྍ፟
ၹੰ̰ຏߖ߹Җঽጯ̝ࡁտྤफ़Ą
Ϥ ώ ͛ ѩ ᜕ ந ፟ ၹ ੰ ̰ ຏ ߖ ൴ Ϡ ޘ ࠎ 4.110/00Ă̙֭ͧ˘ਠާّᗁੰҲ20ĄЯѩྍ፟ၹ
ੰ̰ຏߖგט۞̍үĂ̪ߏג̙टቤ۞ְ၁Ąд
઼̰ĂϤٺܜഇ᜕፟ၹ۞გநᝋ̙֭ԆБᛳٺ
߆ಏҜĂЯѩ၆ٺੰ̰ຏߖგט̍ү˯۞ࢋ
ՐĂــڱར၁ćѩѣޞ࠹ᙯಏҜ۞םአᄃЪ үĄдར၁ܜഇ᜕፟ၹ۞ຏߖგט̍ү̚ĂҌ
͌ᑕઇזĈ( ˘ ) ޙၹຏߖგט̝ඕၹᖐͽซ ҖБࢬႾീ̈́߆ඉࢍ൪۞ଯજĂ̚Βӣཏࡎ൴
ٕள૱ཏჸְІ̝ந7,11,12ć( ˟ ) ̍үˠࣶ̈́ҝϔ ઉგநĂՏѐᅮ૱ఢڦड߹Җّຏ݂ࠪࡺ12-13ć (ˬ ) ຏߖҝϔ̝გநĂ͍ߏΞͽϡຏߖგטନ ߉ΐͽ֨۞࣎९12ć( α ) ѣԩᘽّෂঀҝϔ̝
გநĂΒӣેҖᗓନ߉ͽᔖҺঽෂ็ᇫ10,16Ą
ඕኢ
ᄂ៉᛬ˠ˾ቁ၁дుѐᆧΐĂனҖઉܲග
;͞ё۞ࢨט̈́ۤົඕၹ۞ԼតĂֹˢҝܜഇ
᜕፟ၹ۞ҝϔϺົ͟ৈᆧΐĄ࠹ྵٺާّᗁᒚ
፟ၹĂܜഇ᜕፟ၹ۞ຏߖგטߏྵజنர۞˘
ᒖĄֶፂώࡁտ۞ඕڍĂՀᙋ၁ܜഇ᜕፟ၹд ޙϲੰ̰ຏߖგט۞̍үĂ۞ቁ̏ߏג̙टቤĄ
˵ΪѣтѩĂܜഇ᜕፟ၹ۞᜕ݡኳĂ̖ਕᒔ
Հซ˘Վ۞ܲᅪᄃ̙ᕝ۞೩چĄ
ܑ˘Ĉ᜕ந̝छЧొҜຏߖ൴Ϡޘ۞઼̰γ͛ᚥͧྵ
ຏߖొҜ ຏߖ൴Ϡޘ0/00
͛ᚥ UTI BSI RTI SKIN GI EENT
ώ͛ 1.71 0.55 1.54 0.30
ᄁඈ ( 2004 ) 2.09 2.52 0.68
Engelhar ( 2005 ) 1.01 2.16 1.24 0.20 0.7
Nicolle ( 1996 ) 0.46-4.4 0.1-2.4 Ŵ 0.1-2.1 0-0.9
ણ҂͛ᚥ
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Nosocomial Infection in
One Long Term Care Facility ę A Nursing Home
Chun-Ming Lee1,2,4,5, Ya-Ling Chen2, and Chia-Ling Yang3
Life spans of elderly people are increasing due to medical advances. Increased population of elderly peo- ple leads to more need of long term care facilities. Because there were special situations in residents of long term care facilities, nosocomial infections are not uncommon. Many studies about long term care facilities were pre- sent in foreign countries but there were only few studies in our country from the literature review. This is a prospec- tive study that we analyzed the infection density, sites, sources and organisms of nosocomial infection in one long term care facilities- a nursing home. From October 1, 2003 to September 30, 2005, 2- year duration, there were total 54,468 patient-hospitalization days and the nosocomial infection density was 4.110/00. The total 224 patient- episodes nosocomial infections were reported in 98 patients, and mean age was 79.6 year. Urinary tract infec- tion was the most frequent 42%(94/224), followed by respiratory tract infection 37.5%(84/224) and blood stream infection 13.4%(30/224). A total of 175 strains of microorganisms were isolated, 70.3%(123/175) were Gram- negative organisms and 26.3%(46/175) were Gram- positive organisms and 3.4%(6/175) was viral infection.
Among these, Escherichia coli were 19.4%(34/175) and Pseudomonas aeruginosain 16%(28/175), Proteus mirabilisin 12%(21/175) and staphylococcus aureus in 9.1%(16/175), respectively. Multiple drugs resistant pathogens were not infrequently seen in this long term care facilities and extended spectrum beta lactamase Escherichia coliwas 35.3%(12/34), extended spectrum beta lactamase Klebsiella pneumoniaewas 36.4%(4/11) and all the Staphylococcus aureusbelong to Methicillin resistant Staphylococcus aureus(16/16). Further study needed to find the cause of multiple drugs resistant organisms in this long term care facilities. ( J Intern Med Taiwan 2008; 19: 331-336 )
1Department of Internal Medicine, 2Infection Control Center, 3Nurse Department, Mackay Medicine, Nursing and 4Management College, 5Taipei Medical University,
Mackay Memorial Hospital, Taipei, Taiwan
