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.
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.
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?
Cites: Intern Med J. 2012 Jul;42(7):e157-6421241444
The antibiotic susceptibility of consecutive isolates of the upper respiratory tract pathogens Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae, Branhamella catarrhalis, and Staphylococcus aureus, (100 strains of each species collected each year during March through April 1985, 1988 and 1992) to penicillin V, amoxycillin, cefaclor, cefuroxime, doxycycline, erythromycin, and cotrimoxazole was investigated by MIC determination on PDM and PDM II agar. The MICs of the upper respiratory isolates from 1992 supplemented with 100 isolates each of Escherichia coli, Klebsiella spp., Enterobacter cloacae, Proteus mirabilis and Staphylococcus saprophyticus collected during 1992 were determined against the above antibiotics plus cefadroxil, cefpodoxime, roxithromycin, ciprofloxacin, ofloxacin, and BAY Y 3118. Beta-lactamase production was found in 10% of H. influenzae and 80-90% of S. aureus and B. catarrhalis in 1992. Among H. influenzae isolates, non-beta-lactamase-induced resistance to all beta-lactam antibiotics was first detected in 1988 and amounted to 3% of isolates in 1992. Decreased susceptibility of S. preumoniae to penicillin (> or = 0.12 mg/l), co-trimoxazole > or = 32 mg/l, doxycycline (> or = 2 ml/l) and erythromycin (> or = 1 mg/l) was detected in 11%, 7%, and 8%, respectively, in 1992, which is significantly higher than in previous years at the same laboratory. Decreased susceptibility of S. pyogenes to doxycycline and erythromycin was detected in 11% and 9% in 1992. The two most recently developed antibiotics, cefpodoxime and BAY Y 3118, showed high antibacterial activity. The study emphasizes the need to screen for resistance mechanisms such as beta-lactamase production and lowered penicillin affinity.