The prevalence of multidrug resistant Gramnegative organisms is increasing worldwide. The Infectious Diseases Society of America has previously singled out groups of pathogens with the highest threat, the majority of which are Gram-negative bacilli. These isolates are prevalent not only in intensive-care units of acute-care facilities, but are also found among residents of long-term care facilities with various levels of care, and occasionally among patients without exposure to healthcare systems. Advanced age is an independent predictor for carriage of many of these organisms, and elderly patients are subjected to worse outcomes following the acquisition of resistant Gram-negatives. Due to their frequent admissions and transfers across different healthcare facilities within a region, the elderly constitute important epidemiological reservoirs for these bacteria. Containing the acquisitions of resistant Gramnegatives among the elderly could be achieved through reduction of either 1) selective pressure (e.g. less antibiotics) or 2) colonization pressure (e.g. less exposure to resistant bacteria). This manuscript will review the present situation of multidrug resistant Gram-negative organisms, especially among the elderly, and the infection control interventions that might mitigate their further spread.