Antimicrobial susceptibilities of urinary pathogens in a multidisciplinary long-term care facility.
In order to determine bacterial distribution and antimicrobial susceptibility of urinary pathogens in a long-term-care-facility (LTCF), urine cultures were examined when clinically indicated. The LTCF consists of 286 beds, housing 931 residents during 32 months, in various wings; independent and frail residents (wing-A), nursing and demented patients (wing-B), and skilled-nursing patients (wing-C). A total of 1,401 positive urine cultures were obtained: E. coli was isolated significantly less often in wing-C than in wing-A (p = 0.02) and wing-B (p = 0.009). There was no significant difference in frequency of other organisms. Susceptibility of organisms decreased significantly from wing-C to wing-B (p < 0.05-0.001), and from wing-B to wing-A (p < 0.05-0.001). Susceptibility rates' decreased significantly over time in wing-B, less in wing-C and not at all in wing-A.


CONCLUSIONS
When selecting empiric antibiotic therapy for serious urinary tract infection in a long-term-care resident, one should take into account the microbial environment of the individual patient's department.
Friedmann
Reuven
R
Neve-Horim Home for the Elderly, P.O.B 888, Jerusalem 91008, Israel. Reufri@yahoo.com
Hamburger
Raphael
R
Shulman
Chaim
C
Yinnon
Amos M
AM
Raveh
David
D
D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D001437:Bacteriuria / Q000188:drug therapy / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D006801:Humans; D008134:Long-Term Care; D008826:Microbial Sensitivity Tests; D012866:Skilled Nursing Facilities; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology; D014556:Urine / Q000382:microbiology
D000900:Anti-Bacterial Agents