Antibiotic resistance patterns of bacteria causing urinary tract infections in the elderly living in nursing homes versus the elderly living at home: an observational study

BMC Geriatrics

Dag Berild³  Dagfinn Skaare⁴  Maria Romøren²  Harald Reiso²  Nils Grude⁴  Morten Lindbæk¹  Mark Fagan² 

[1] Antibiotic Centre for Primary Care, University of Oslo, Postboks 1130, Blindern 0318, , Oslo, Norway;Institute of Health and Society, Faculty of Medicine, University of Oslo, Postboks 1130, Blindern 0318, , Oslo, Norway;Department of Infectious Disease, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Nydalen 0424, , Oslo, Norway;Department of Microbiology, Vestfold Hospital Trust, Tønsberg, Postboks 2168, Tønsberg, 3103, Norway

关键词: Guidelines;    Geriatrics;    Nursing home;    Antibiotic stewardship;    Antibiotic resistance;    Urinary tract infection;   

Others  :  1223049
DOI  :  10.1186/s12877-015-0097-x

 received in 2015-04-08, accepted in 2015-07-23,  发布年份 2015

【 摘 要 】

Background

Antibiotic resistance is a problem in nursing homes. Presumed urinary tract infections (UTI) are the most common infection. This study examines urine culture results from elderly patients to see if specific guidelines based on gender or whether the patient resides in a nursing home (NH) are warranted.

Methods

This is a cross sectional observation study comparing urine cultures from NH patients with urine cultures from patients in the same age group living in the community.

Results

There were 232 positive urine cultures in the NH group and 3554 in the community group. Escherichia coli was isolated in 145 urines in the NH group (64 %) and 2275 (64 %) in the community group. There were no clinically significant differences in resistance.

Combined, there were 3016 positive urine cultures from females and 770 from males. Escherichia coli was significantly more common in females 2120 (70 %) than in males 303 (39 %)(p < 0.05). Enterococcus faecalis was significantly less common in females 223(7 %) than males 137 (18 %) (p < 0.05). For females, there were lower resistance rates to ciprofloxacin among Escherichia coli (7 % vs 12 %; p < 0.05) and to mecillinam among Proteus mirabilis (3 % vs 12 %; p < 0.05).

Conclusions

Differences in resistance rates for patients in the nursing home do not warrant separate recommendations for empiric antibiotic therapy, but recommendations based on gender seem warranted.

【 授权许可】

   
2015 Fagan et al.

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