Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-30T20:13:51.236Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  02 January 2015

David T. Bjork ,
Lawrence L. Pelletier  and
Robert R. Tight
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
Get access Rights & Permissions [Opens in a new window]

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
Information
Infection Control & Hospital Epidemiology , Volume 5 , Issue 4 , April 1984 , pp. 173 - 176
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1984

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Beeson, PB: The case against the catheter. Am J Med 1958;24:1–3.CrossRefGoogle ScholarPubMed
2.Kunin, CM: Detection, Prevention and Management of Urinary Tract Infections, ed 3, Philadelphia, Lea and Febiger, 1979.Google Scholar
3.Magnussen, MH, Robb, SS: Nosocomial infections in a long-term care facility. Am J Infect Control 1980;8:12–17.CrossRefGoogle ScholarPubMed
4.Garibaldi, RA, Brodine, S, Matsumiya, S: Infections among patients in nursing homes. N Engl J Med 1981;305:731–735.CrossRefGoogle ScholarPubMed
5.Alling, B, Bandberg, A, Seedberg, S, et al: Aerobic and anaerobic microbial flora in the urinary tract of geriatric patients during long-term care. J Infect Dis 1973;127:34–39.CrossRefGoogle ScholarPubMed
6.Weinstein, RA, Nathan, C, Gruensfelder, R, et al: Endemic aminoglycoside resistance in gram-negative bacilli: Epidemiology and mechanisms. J Infect Dis 1980;141:338–345.CrossRefGoogle ScholarPubMed
7.Schaberg, DR, Weinstein, RA, Stamm, WE: Epidemics of nosocomial urinary tract infections caused by multiply resistant gram-negative bacilli: Epidemiology and control. J Infect Dis 1976;133:363–366.CrossRefGoogle ScholarPubMed
8.Schaberg, DR, Alford, RH, Anderson, R, et al: An outbreak of nosocomial infection due to multiply resistant Serratia marcescens: Evidence of interhospital spread. J Infect Dis 1979;134:181–188.CrossRefGoogle Scholar
9.Gerding, DN, Buxton, AE, Hughes, RA, et al: Nosocomial multiply resistant Klebsiella pneumoniae: Epidemiology of an outbreak of apparent index case origin. Antimicrob Agents Chemother 1979;15:608–615.CrossRefGoogle ScholarPubMed
10.Garibaldi, RA, Burke, JP, Dickmas, ML, et al: Factors predisposing to bacteriuria during indwelling urethral catheterization. N Engl J Med 1974;291:215–219.CrossRefGoogle ScholarPubMed
11.Warren, JW, Platt, R, Thomas, RJ, et al: Antibiotic irrigation and catheter-associated urinary-tract infections. N Engl J Med 1978;299:570–573.CrossRefGoogle ScholarPubMed
12.Selden, R, Lee, S, Wang, WL, et al: Nosocomial klebsiella infections: Intestinal colonization as a reservoir. Ann Intern Med 1971;74:657–664.CrossRefGoogle ScholarPubMed
13.Schaberg, DR, Highsmith, AK, Wachsmuth, IK: Resistance plasmid transfer by Serratia marcescens in urine. Antimicrob Agents Chemother 1977;11:449–450.CrossRefGoogle ScholarPubMed
14.Casewell, MW, Webster, M, Dalton, MT, et al: Gentamicin-resistant klebsiella aerogenes in a urological ward. Lancet 1977; 2(8035):444–446.CrossRefGoogle Scholar
15.Sadowski, PL, Peterson, BC, Gerding, DN, et al: Physical characterization of ten R plasmids obtained from an outbreak of nosocomial klebsiella pneumoniae infections. Antimicrob Agents Chemother 1979;15:616–624.CrossRefGoogle Scholar
16.Tompkins, LS, Plorde, JJ, Falkow, S: Molecular analysis of R-factors from multiresistant nosocomial isolates. J Infect Dis 1980;141:625–636.CrossRefGoogle ScholarPubMed
17.Maki, DG, Hennekens, CH, Bennett, JV: Prevention of catheter-associated urinary tract infection. JAMA 1972;221:1270–1271.CrossRefGoogle ScholarPubMed
18.Stamm, WE: Guidelines for prevention of catheter-associated urinary tract infections. Ann Intern Med 1975;82:386–390.CrossRefGoogle ScholarPubMed
19.Wong, ES, Hooton, TM: Guidelines for the prevention and control of nosocomial infections. Infect Control 1981;2:119–130.Google Scholar