[Incidence and clinical characteristics of symptomatic urinary infections in a geriatric hospital].
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.
Haber
N
N
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
Paute
J
J
Gouot
A
A
Sevali Garcia
J
J
Rouquet
M-L
ML
Sahraoui
L
L
Gamard
M-N
MN
Jarlier
V
V
Chaibi
P
P
Cambau
E
E
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*
D000900:Anti-Bacterial Agents