title: [Incidence and clinical characteristics of symptomatic urinary infections in a geriatric hospital].
abstract: OBJECTIVES AND SETTINGS: The authors had for aim to study the incidence of symptomatic urinary infections (SUTI) in elderly patients, to describe their clinical and microbiologic characteristics and first-line treatment in a geriatric hospital with 902 beds: 124 in acute care (ACF), 293 in rehabilitation and intermediate-care (RICF), and 485 in long-term-care-facilities (LTCF).
  
  
  METHODS
  During two months in 2003, all positive urine cultures detected by the laboratory were sent to the clinician with a questionnaire on clinical signs, diagnosis of SUTI and antibiotic treatment.
  
  
  RESULTS
  SUTI was diagnosed in 85 out of 204 positive urine cultures (40%). The incidence of SUTI was 1.86 per 1,000 patient-days (with rates of 2.63, 2.49, 1.41 per 1,000 patients-days for the ACF, RICF, LTCF respectively). For 51 cases (60%) there were only general symptoms, for 24 cases (28.2%) there were only urinary symptoms, and for 10 cases (11.8%) there were both. Escherichia coli and Proteus mirabilis were the main bacterial species involved in 57 and 14% respectively. E. coli strains were 59% resistant to amoxicillin, 55% resistant to amoxicillin-clavulanic acid, and 39% resistant to fluoroquinolones. The main antibiotics were fluoroquinolones, ceftriaxone, and amoxicillin-clavulanate, prescribed respectively in 52.5, 19, and 9% of the cases.
  
  
  CONCLUSIONS
  SUTI was diagnosed in only in 40% of positive urine cultures from elderly patients hospitalized in our hospital. To improve the management of SUTI in this population, we changed our recommendations for diagnosis and treatment.
authors.affiliation: Equipe opérationnelle d'hygiène, groupe hospitalier Charles-Foix-Jean-Rostand, Assistance publique-Hôpitaux de Paris, 94000 Ivry-Sur-Seine, France. nicole.haber@crc.aphp.fr
authors.forename: N
authors.initials: N
authors.lastname: Haber
authors.forename: J
authors.initials: J
authors.lastname: Paute
authors.forename: A
authors.initials: A
authors.lastname: Gouot
authors.forename: J
authors.initials: J
authors.lastname: Sevali Garcia
authors.forename: M-L
authors.initials: ML
authors.lastname: Rouquet
authors.forename: L
authors.initials: L
authors.lastname: Sahraoui
authors.forename: M-N
authors.initials: MN
authors.lastname: Gamard
authors.forename: V
authors.initials: V
authors.lastname: Jarlier
authors.forename: P
authors.initials: P
authors.lastname: Chaibi
authors.forename: E
authors.initials: E
authors.lastname: Cambau
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy / Q000503:physiopathology*; D005602:France / Q000453:epidemiology; D006782:Hospitals, Special; D006801:Humans; D015994:Incidence; D007297:Inpatients; D011795:Surveys and Questionnaires; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*
chemical_list: D000900:Anti-Bacterial Agents