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

Research Article

Dag Berild¹  Nils Grude²  Dagfinn Skaare²  Mark Fagan³  Harald Reiso³  Maria Romøren³  Morten Lindbæk⁴ 

[1] Department of Infectious Disease, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, PO Box 4950, 0424,, Nydalen, Oslo, Norway;Department of Microbiology, Vestfold Hospital Trust, Tønsberg, Postboks 2168, 3103, Tønsberg, Norway;Institute of Health and Society, Faculty of Medicine, University of Oslo, Postboks 1130, 0318,, Blindern, Oslo, Norway;Institute of Health and Society, Faculty of Medicine, University of Oslo, Postboks 1130, 0318,, Blindern, Oslo, Norway;Antibiotic Centre for Primary Care, University of Oslo, Postboks 1130, 0318,, Blindern, Oslo, Norway;

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

DOI  :  10.1186/s12877-015-0097-x

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

来源: Springer

【 摘 要 】

BackgroundAntibiotic 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.MethodsThis 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.ResultsThere 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).ConclusionsDifferences 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】

CC BY   
© Fagan et al. 2015