pneumoniae (MDRSP) that are resistant to penicillin and other broad-spectrum agents such as macrolides and fluroquinolones (18, 19). In some residential settings (e.g., LTCFs), it is important to control multidrug-resistant S. In addition to Escherichia coli and Klebsiella pneumoniae, these include strains of Acinetobacter baumannii resistant to all antimicrobial agents, or all except imipenem, (6-12), and organisms such as Stenotrophomonas maltophilia (12-14), Burkholderia cepacia (15, 16), and Ralstonia pickettii (17) that are intrinsically resistant to the broadest-spectrum antimicrobial agents. In addition to MRSA and VRE, certain GNB, including those producing extended spectrum beta-lactamases (ESBLs) and others that are resistant to multiple classes of antimicrobial agents, are of particular concern. These highly resistant organisms deserve special attention in healthcare facilities (2).
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