title: Antibiotic resistance patterns of bacteria causing urinary tract infections in the elderly living in nursing homes versus the elderly living at home: an observational study.
abstract: BACKGROUND
  Antibiotic resistance is a problem in nursing homes. Presumed urinary tract infections (UTI) are the most common infection. This study examines urine culture results from elderly patients to see if specific guidelines based on gender or whether the patient resides in a nursing home (NH) are warranted.
  
  
  METHODS
  This is a cross sectional observation study comparing urine cultures from NH patients with urine cultures from patients in the same age group living in the community.
  
  
  RESULTS
  There were 232 positive urine cultures in the NH group and 3554 in the community group. Escherichia coli was isolated in 145 urines in the NH group (64%) and 2275 (64%) in the community group. There were no clinically significant differences in resistance. Combined, there were 3016 positive urine cultures from females and 770 from males. Escherichia coli was significantly more common in females 2120 (70%) than in males 303 (39%) (p < 0.05). Enterococcus faecalis was significantly less common in females 223 (7%) than males 137 (18%) (p < 0.05). For females, there were lower resistance rates to ciprofloxacin among Escherichia coli (7% vs 12%; p < 0.05) and to mecillinam among Proteus mirabilis (3% vs 12%; p < 0.05).
  
  
  CONCLUSIONS
  Differences in resistance rates for patients in the nursing home do not warrant separate recommendations for empiric antibiotic therapy, but recommendations based on gender seem warranted.
authors.affiliation: Institute of Health and Society, Faculty of Medicine, University of Oslo, Postboks 1130, Blindern, 0318, , Oslo, Norway. markfagannor@gmail.com.
authors.forename: Mark
authors.initials: M
authors.lastname: Fagan
authors.affiliation: Institute of Health and Society, Faculty of Medicine, University of Oslo, Postboks 1130, Blindern, 0318, , Oslo, Norway. morten.lindbak@medisin.uio.no.|Antibiotic Centre for Primary Care, University of Oslo, Postboks 1130, Blindern, 0318, , Oslo, Norway. morten.lindbak@medisin.uio.no.
authors.forename: Morten
authors.initials: M
authors.lastname: Lindbæk
authors.affiliation: Department of Microbiology, Vestfold Hospital Trust, Tønsberg, Postboks 2168, 3103, Tønsberg, Norway. nigrud@siv.no.
authors.forename: Nils
authors.initials: N
authors.lastname: Grude
authors.affiliation: Institute of Health and Society, Faculty of Medicine, University of Oslo, Postboks 1130, Blindern, 0318, , Oslo, Norway. harald.reiso@medisin.uio.no.
authors.forename: Harald
authors.initials: H
authors.lastname: Reiso
authors.affiliation: Institute of Health and Society, Faculty of Medicine, University of Oslo, Postboks 1130, Blindern, 0318, , Oslo, Norway. maria.romoren@medisin.uio.no.
authors.forename: Maria
authors.initials: M
authors.lastname: Romøren
authors.affiliation: Department of Microbiology, Vestfold Hospital Trust, Tønsberg, Postboks 2168, 3103, Tønsberg, Norway. dagfinn.skaare@siv.no.
authors.forename: Dagfinn
authors.initials: D
authors.lastname: Skaare
authors.affiliation: Department of Infectious Disease, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, PO Box 4950, Nydalen, 0424, , Oslo, Norway. dag.berild@medisin.uio.no.
authors.forename: Dag
authors.initials: D
authors.lastname: Berild
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000892:Anti-Infective Agents, Urinary / Q000145:classification / Q000494:pharmacology; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects*; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data*; D008297:Male; D009664:Norway / Q000453:epidemiology; D009735:Nursing Homes / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011512:Proteus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D011513:Proteus mirabilis / Q000187:drug effects*; D012737:Sex Factors; D016482:Urinalysis / Q000379:methods; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000892:Anti-Infective Agents, Urinary