title: Proteeae species bacteriuria accompanying Proteeae species groin skin carriage in geriatric outpatients.
abstract: There have been numerous reports of Proteeae species urinary tract infections among elderly individuals. To explore a possible urinary carrier source of Proteeae species in this population, the frequency of aerobic gram-negative bacillus (AGNB) bacteriuria at the greater than or equal to 10(2)/ml level was determined in 67 ambulatory elderly outpatients classified as to Proteeae group (Morganella, Proteus, Providencia) groin carriage by a set of two skin cultures obtained at least 1 week apart. None had urethral catheters, symptomatic infections, skin ulcers, or recent antibiotic therapy. We found AGNB bacteriuria in 12 of 15 carriers (80%) and in 21 of 52 noncarriers (40%) (P = 0.009). Proteeae species bacteriuria occurred in eight carriers (53.3%) and six noncarriers (11.5%) (P = 0.001). At the 10(2) to 10(4)/ml level, Proteeae species were isolated in urine specimens from seven carriers (46.7%) and four noncarriers (7.7%) (P = 0.001). There was concordance of species of skin and urine Proteeae isolates in six carriers. By contrast, non-Proteeae AGNB bacteriuria at any level was present in four Proteeae species carriers (26%) and 15 noncarriers (28.8%) (P greater than 0.05). There was a 36.7% frequency of Proteeae species bacteriuria in nursing home residents, in contrast to 8.1% among those living in private homes; this parallels the greater frequency of Proteeae species groin carriage among nursing home residents in the study population. Low-level urinary colonization with Proteeae species accompanying Proteeae species groin skin colonization in elderly individuals is a hitherto unrecognized finding. This may account for the greater frequency of Proteeae species urinary infections in this population.
authors.affiliation: Florida Consortium for Infection Control, Miami 33143.
authors.forename: N J
authors.initials: NJ
authors.lastname: Ehrenkranz
authors.forename: B C
authors.initials: BC
authors.lastname: Alfonso
authors.forename: D G
authors.initials: DG
authors.lastname: Eckert
authors.forename: L B
authors.initials: LB
authors.lastname: Moskowitz
mesh_terms: D000368:Aged; D001437:Bacteriuria / Q000382:microbiology*; D002353:Carrier State / Q000382:microbiology*; D004755:Enterobacteriaceae / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000382:microbiology*; D006119:Groin; D006707:Homes for the Aged; D006801:Humans; D009735:Nursing Homes; D011511:Proteus / Q000302:isolation & purification; D011512:Proteus Infections / Q000382:microbiology; D011513:Proteus mirabilis / Q000302:isolation & purification; D011532:Providencia / Q000302:isolation & purification; D012874:Skin Diseases, Infectious / Q000382:microbiology*