Antibiotic resistance in elderly patients: Comparison of Enterobacterales causing urinary tract infections between community, nursing homes and hospital settings

Objective: The objective was to compare the prevalence of antibiotic resistance of, Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae in elderly patients in, three sectors: community, nursing homes, and hospital settings.Material and methods: This study was a retrospective observational study conducted in, Bourgogne Franche-Comte (France). We collected positive urine samples from, patients over 75 years of age from six private laboratories.Results: Antibiotic resistance rate for E. coli in nursing homes was close to that of the, ommunity setting. Conversely, resistance of K. pneumoniae in nursing homes was, close to hospital settings. No difference in resistance of P. mirabilis was observed, between the three healthcare sectors.Conclusions: Patients living in nursing homes should not be considered more at risk of, infection by multidrug resistant E. coli than patients living in community setting. Screening of multi-drug resistant K. pneumoniae could be of interest for nursing home, patients.

Automated summary

This study compared the antibiotic resistance rates of Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae in elderly patients in community, nursing home, and hospital settings. The results showed that the antibiotic resistance rate of E. coli in nursing homes was similar to that in the community setting, while the resistance rate of K. pneumoniae in nursing homes was similar to that in hospital settings. No difference in antibiotic resistance of P. mirabilis was observed between the three healthcare sectors. Therefore, patients living in nursing homes should not be considered more at risk of infection by multi-drug resistant E. coli than patients living in the community setting. Screening for multi-drug resistant K. pneumoniae may be beneficial for nursing home patients.