TY - JOUR
T1 - Urinary tract infections in non-catheterized nursing home residents
AU - Schultz, Barry M.
AU - Gupta, Krishan L.
AU - Humbach, Eva
AU - Baker, Peggy
AU - Escher, Jeffrey E.
AU - Gambert, Steven R.
PY - 1991/1/1
Y1 - 1991/1/1
N2 - Sixty-five elderly non-catheterized residents of a 275 bed skilled nursing home had 119 separate urinary tract infections as determined by the presence of clinical signs and symptoms as well as a urine culture demonstrating > 105 CFU of a known pathogen between January 1 and June 30, 1989 (mean 1.8 per person). Pyuria was noted in all but 7 infections and all responded clinically to treatment. Presenting signs or symptoms included fever (59.1%), change in mental status (12.4%), genitourinary symptoms (11.7%), lethargy (7.6%), among others. Despite the nursing home's close proximity to an acute hospital where a relatively high incidence of virulent and multiply resistant organisms would be expected, Escherichia coli was the most common infecting organism. It was of note, however, that 30% of the Escherichia coli were resistant to at least one antibiotic. Although women were infected most commonly, no relationship was found to coexisting illness, level of mobility, 6 month mortality, or frequency of hospitalization. Since clinical improvement was noted in all cases, there should be a high index of suspicion for UTI in this population. Due to the large number of atypical and/or nonspecific presentations of UTIs in this population, caution is advised to not too quickly label a urinary tract infection as being an "asymptomatic" bacteriuria.
AB - Sixty-five elderly non-catheterized residents of a 275 bed skilled nursing home had 119 separate urinary tract infections as determined by the presence of clinical signs and symptoms as well as a urine culture demonstrating > 105 CFU of a known pathogen between January 1 and June 30, 1989 (mean 1.8 per person). Pyuria was noted in all but 7 infections and all responded clinically to treatment. Presenting signs or symptoms included fever (59.1%), change in mental status (12.4%), genitourinary symptoms (11.7%), lethargy (7.6%), among others. Despite the nursing home's close proximity to an acute hospital where a relatively high incidence of virulent and multiply resistant organisms would be expected, Escherichia coli was the most common infecting organism. It was of note, however, that 30% of the Escherichia coli were resistant to at least one antibiotic. Although women were infected most commonly, no relationship was found to coexisting illness, level of mobility, 6 month mortality, or frequency of hospitalization. Since clinical improvement was noted in all cases, there should be a high index of suspicion for UTI in this population. Due to the large number of atypical and/or nonspecific presentations of UTIs in this population, caution is advised to not too quickly label a urinary tract infection as being an "asymptomatic" bacteriuria.
KW - Urinary tract infections
KW - asymptomatic bacteriuria
KW - nursing home residents
UR - http://www.scopus.com/inward/record.url?scp=0343611620&partnerID=8YFLogxK
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U2 - 10.1007/BF00451859
DO - 10.1007/BF00451859
M3 - Article
AN - SCOPUS:0343611620
VL - 1
SP - 29
EP - 34
JO - Geriatric Nephrology and Urology
JF - Geriatric Nephrology and Urology
SN - 0924-8455
IS - 1
ER -