Abstract

Objective: Urinary tract infection is one of the most common bacterial diseases in elderly patients. The objective of this study is to determine the antibiotic resistance rates against first-line antibiotics used for the treatment of community-acquired urinary tract infections in elderly patients at our hospital, and use the results as guidance for empirical antibiotic therapy. 

Methods: In this study, data on all elderly patients aged 65 and older who were followed and treated in our hospital between March 2010 and March 2012 were evaluated retrospectively.

Results: 406 microorganisms were isolated from the urine cultures of 401 patients included in the study, because 5 (1.2%) patients harbored two microorganisms. Of the 406 microorganisms, 320 (78.8%) were Gram-negative bacilli, 72 (17.7%) were Gram-positive cocci and 14 (3.5%) were Candida spp. Escherichia coli (n=262, 64.5%), Klebsiella pneumoniae (n=27, 6.6%), and Pseudomonas aeruginosa (n=17, 4.1%) were the most common among Gram-negatives, and Enterococcus faecalis (n=36, 8.9%) and coagulase-negative staphylococci (n=25, 6.2%) were the most common among Gram-positives. Susceptibility rates of  E. coli strains were 89% for nitrofurantoin, 81% for trimethoprim-sulfamethoxazole, 77% for amoxicillin-clavulanic acid, 70% for gentamicin and 66% for ciprofloxacin. 

Conclusions: Antimicrobial resistance must be monitored at each hospital in order to make correct choices for empirical antibiotic therapy. Surveillance studies are helpful for this purpose. In conclusion, nitrofurantoin and trimethoprim-sulfamethoxazole can safely be used for the empirical treatment of urinary tract infections in elderly patients.