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Urinary Tract Infections with Antibiotic Resistant Organisms in Catheterized Nursing Home Patients

Published online by Cambridge University Press:  02 January 2015

David T. Bjork*
Affiliation:
Department of Medicine, University of North Dakota School of Medicine and Veterans Administration Hospital, Fargo, North Dakota and theVeterans Administration Hospital, Tacoma, Washington
Lawrence L. Pelletier
Affiliation:
Department of Medicine, University of North Dakota School of Medicine and Veterans Administration Hospital, Fargo, North Dakota and theVeterans Administration Hospital, Tacoma, Washington
Robert R. Tight
Affiliation:
Department of Medicine, University of North Dakota School of Medicine and Veterans Administration Hospital, Fargo, North Dakota and theVeterans Administration Hospital, Tacoma, Washington
*
Fergus Falls Medical Group, 615 South Mill Street, Fergus Falls, MN 56537

Abstract

Long-term use of indwelling urinary catheters in nursing home (NH) patients is a potential cause of significant morbidity. We retrospectively studied 10 NH patients with chronic indwelling urinary catheters. Sixty-four percent of all 84 antibiotic courses prescribed were for bacteriuria alone without clinical infection. Seventy percent of 63 antibiotic courses were followed by bacteriuria with organisms resistant to the antibiotic administered. Bacteria isolated from NH patients often displayed greater resistance to specific antibiotics than those isolated from hospitalized patients. Four of the 20 urinary tract infections were associated with bacteremia. Three episodes of bacteremia were with highly-resistant organisms and one was fatal. Use of urinary catheters and inappropriate use of antibiotics in NH patients results in urinary tract colonization and infection with resistant bacteria and is an important cause of morbidity and mortality.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1984

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