title: Urine cultures from indwelling bladder catheters in nursing home patients: a point prevalence study in a Swedish county.
abstract: OBJECTIVE
  To survey the bacterial flora and antibiotic resistance in urinary strains from patients with indwelling bladder catheters residing in nursing homes within a geographically defined region.
  
  
  METHODS
  Urine was sampled for culture from 163 catheter patients (126 men and 37 women) during a 2 week period in March 2010. Susceptibility testing of the isolated bacteria was compared with all urinary strains (n = 9994) from hospitals and primary healthcare in the same geographical area cultured during the first 6 months of 2010 (control group).
  
  
  RESULTS
  Bacteriuria was found in 159 of 163 urine samples (98%). Enterococcus faecalis and Escherichia coli were the most common species, one or both being detected in 72% of the urine samples, while Proteus species were found in10% and a single isolate of Providentia species was seen.Strains in the study patients were more resistant to antibiotics than in the control group. Particularly large differences were noted for ciprofloxacinin in E. coli (16.9% vs 7.9%) and for trimethoprim-sulfamethoxazole in E. faecalis (39.1% vs 24.8%). One extended spectrum β-lactamase (ESBL)-producing E. coli was cultured (1.3%), compared with 1.6% in the control group. No vancomycin-resistant enterococci (VRE) or methicillin-resistant Staphylococcus aureus (MRSA) were detected.
  
  
  CONCLUSIONS
  Proteus mirabilis and Providentia species were rarely isolated, in sharp contrast to previous studies from geriatric hospital wards where they have often been in the majority. The limited incidence of ESBL and the absence of VRE and MRSA is gratifying, but the high resistance to antibiotics needs to be assessed on a continuous basis.
authors: Departments of Research and Development, and Clinical Microbiology , Unilabs, Skaraborgs Sjukhus, Skövde , Sweden.
authors: Karin
authors: K
authors: Jonsson
authors: Berndt E B
authors: BE
authors: Claesson
authors: Hans
authors: H
authors: Hedelin
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001437:Bacteriuria / Q000188:drug therapy / Q000453:epidemiology*; D002408:Catheters, Indwelling / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D013293:Enterococcus faecalis / Q000302:isolation & purification; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D010045:Outpatients; D015995:Prevalence; D011513:Proteus mirabilis / Q000302:isolation & purification; D011532:Providencia / Q000302:isolation & purification; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology; D001743:Urinary Bladder / Q000382:microbiology*; D014556:Urine / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents