[Microbial description of bacteriuria in long-term care facilities: a prospective study in the French Teaching Hospital of Strasbourg].
OBJECTIVE
The authors had for aim to assess, the incidence of symptomatic bacteriuria and the level of antibiotic resistance in bacteria identified in long-term care facilities (LTC).


METHODS
Symptomatic bacteriuria cases were prospectively collected, during 9 months in the two LTC of the Strasbourg French Teaching Hospital (196 beds).


RESULTS
One hundred and eleven bacteriuria cases were included. They concerned 67 of the 274 residents (cumulative incidence: 2.07/1,000 patients-day). A gram-negative bacillus was identified in 85% of the symptomatic bacteriuria cases, and Escherichia coli in 40%. Sixty percent of the identified bacterial strain was resistant to amoxicillin (Amx-R) and 42% to the clavulanic acid combination (AmC-R). Third generation cephalosporins (3GC) were effective in 90% of Urinary tract infections (UTIs) and fluoroquinolones in 65% (Fq). Four bacterias with broad beta-lactamase spectrum were identified (0.04%) including 3 Enterobacter aerogenes. No yeast infection was diagnosed. E. coli strains were 65% Amx-R and 50% AmC-R. Concerning the Fq-R strains (15%), 50% were cotrimoxazole resistant (Stx-R) and 70% Amx-R; 3GC remained effective (82%).


CONCLUSIONS
In LTC, multi-drug resistance bacteria are rare and 3GCs seem to be the best first line treatment. Nevertheless, Fq-R is increasing (15 vs 8%), and attention must be paid to the antibiotic therapy used.
Lang
P-O
PO
Service de Médecine Interne Gériatrique, Pole de Gériatrie, CHRU de Strasbourg, Hôpital de la Robertsau, 83, rue Himmerich, 67091 Strasbourg cedex, France. Pierre-Olivier.LANG@chru-strasbourg.fr
Jehl
F
F
Berthel
M
M
Kaltenbach
G
G
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001437:Bacteriuria / Q000188:drug therapy / Q000453:epidemiology*; D004359:Drug Therapy, Combination; D005260:Female; D005602:France / Q000453:epidemiology; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology; D006784:Hospitals, Teaching / Q000592:standards*; D006801:Humans; D015994:Incidence; D008134:Long-Term Care / Q000592:standards*; D008297:Male
D000900:Anti-Bacterial Agents