More Than a Third of Nursing Home UTIs Involve Antibiotic-Resistant Pathogen

Nine pathogens were behind 90% of all urinary tract infections (UTIs) in nursing homes reported to the National Healthcare Safety Network Long-Term Care Facility Component between 2013 and 2017, according to a study published online in the journal Infection Control & Hospital Epidemiology. 

Researchers analyzed pathogens and antibiotic susceptibility testing results for 5485 UTI events at 243 nursing homes. A total 6157 pathogens were associated with the infections. 

“This is the first summary of antibiotic resistance among common pathogens causing UTIs reported to National Healthcare Safety Network by nursing homes,” researchers wrote. “Improved understanding of the resistance burden among common infections helps inform facility infection prevention and antibiotic stewardship efforts.” 

Of the 9 pathogens associated with 9 out of 10 reported urinary tract infections, Escherichia coli was linked with 41% of UTI events, Proteus species with 14%, and Klebsiella pneumoniae/oxytoca with 13%.

“Among E. coli, fluoroquinolone, and extended-spectrum cephalosporin resistance were most prevalent (50% and 20%, respectively),” researchers reported. 

The highest rates of resistance involved Staphylococcus aureus and Enterococcus faecium. Some 67% of S. aureus infections were methicillin resistant, while 60% of E. faecium infections were vancomycin resistant, according to the study. However, the two pathogens represented less than 5% of pathogens reported.

Multidrug resistance was most common with Pseudomonas aeruginosa, according to the analysis, occurring in 11% of infections.  

“For the resistant phenotypes we assessed,” researchers noted, “36% of all UTIs reported were associated with a resistant pathogen.” 

—Jolynn Tumolo 

Reference:

Eure TR, Stone ND, Mungai EA, Bell JM, Thompson ND. Antibiotic-resistant pathogens associated with urinary tract infections in nursing homes: Summary of data reported to the National Healthcare Safety Network Long-Term Care Facility Component, 2013-2017 [published online ahead of print, 2020 Aug 12]. Infect Control Hosp Epidemiol. 2020;1-6. doi:10.1017/ice.2020.348