[Urinary tract infection in institutionalized elderly patients. Incidence of bacterial resistance and risk factors].
BACKGROUND
The goal of the present work was to study urinary tract infections (UTI) in a sociosanitary center in order to characterize etiology, define sensitivity profiles, and study associations between these profiles and various clinical parameters.


METHODS
A prospective study of all urinary tract infections at the caring unit of a geriatric sociosanitary center was carried out. Antibiograms were performed on all patients in which a UTI was suspected, and the association between the isolated organism or E. coli resistance with various clinical parameters (gender, bed confinement, recurrence, incontinence, neural impairment, basic daily life activities and drug use) was studied using a multivariate logistic regression analysis.


RESULTS
Escherichia coli and Proteus mirabilis are the most commonly isolated organisms (51% and 15%, respectively). The former is associated with bed confinement and the female gender. The latter shows an inverse relation with recurrence in 90 days. Resistance to the antibiotics studied correlates with a number of clinical parameters, although associations vary for each antimicrobial agent. Previous use of antibiotics and recurrence of infection have no influence on resistance.


CONCLUSIONS
Geriatric patients' characteristics may well account for some of the results encountered. However, the development of resistance in the center may be related to spreading from direct contact between patients. The relationship between resistance and drug use may be affected by the external administration, rather than in-center administration, of drugs.
Faus Felipe
V
V
Servicio de Farmacia, Centro Sociosanitario La Florida, Alicante. vfaus@hcs.es
Andreu Lafuente
R
R
Peris Martí
J F
JF
de la Vega Ortega
A
A
Martínez Martínez
M A
MA
D000368:Aged; D000369:Aged, 80 and over; D024881:Drug Resistance, Bacterial; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007326:Institutionalization; D008297:Male; D011446:Prospective Studies; D011512:Proteus Infections / Q000188:drug therapy / Q000453:epidemiology*; D011513:Proteus mirabilis; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000453:epidemiology*