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

Abstract

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.

Sepsis and Other Infectious Disease Emergencies in the Elderly

“…88,96,98,99 Group B streptococcus ( Streptococcus agalactiae ), Staphylococcus saprophyticus , Providencia stuartii , and Pseudomonas aeruginosa are also more frequent causes of UTI in the elderly than younger adults. Laboratory evaluation of UTI in the ED should consist of a urinalysis performed on a clean-catch urine specimen followed by urine culture if positive.…”

“…104 Significant resistance to fluoroquinolones and other antimicrobials have been documented in elderly community-dwelling and long-term care facility populations alike, due in part to widespread and sometimes lax use of antimicrobials. 87,91,98,99,106,107 Antibiograms detailing local antimicrobial resistance patterns for common urinary pathogens can help inform appropriate empiric therapy in the ED. Likewise, close outpatient follow-up to assess for clinical improvement and review of the appropriateness of empiric antimicrobial therapy based on urine culture results can help tailor further management.…”

Analysis of the antimicrobial susceptibility profile of bacteria isolated from urine samples at a hospital in the southeast of Minas Gerais

“…(4) Alguns estudos recentes demonstram o aumento da resistência desses microrganismos aos antimicrobianos disponíveis no mercado e a importância da terapia empírica na evolução clínica do paciente. (4)(5)(6)(7)(8)(9)(10)(11)(12) A resistência aos antimicrobianos de cepas bacterianas isoladas de urina, tanto em ambiente comunitário quanto hospitalar, é um assunto de preocupação mundial, apresentando-se como um problema de saúde pública.…”

Antibiotic Resistance in the Elderly

“…One of the problems causing antibiotic resistance is the misuse of these drugs as in some countries they can be purchased over the counter without a doctor's prescription therefore the correct dose and duration cannot be guaranteed. The emerging problem of antibiotic resistance is a serious threat to global public health6 and a problem in nursing homes therefore threatening the ability to treat infections 7 . Antibiotic resistance is a problem in nursing homes 7 .…”

“…The emerging problem of antibiotic resistance is a serious threat to global public health6 and a problem in nursing homes therefore threatening the ability to treat infections 7 . Antibiotic resistance is a problem in nursing homes 7 . Geriatric facilities are reservoirs for multidrug resistant organisms and other nosocomial pathogens 8 .…”