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Open Access J Gerontol Geriatr Med. 2018 Apr;4(3). pii: 555636. doi: 10.19080/OAJGGM.2018.04.555636. Epub 2018 May 22.

Increased Fluoroquinolone-Susceptibility and Preserved Nitrofurantoin-Susceptibility among Escherichia coli Urine Isolates from Women Long-Term Care Residents: A Brief Report.

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Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT USA.
Department of Internal Medicine, Section of Geriatrics, Yale School of Medicine, New Haven, CT USA.


Suspected urinary tract infection is a common indication for antimicrobial therapy in long-term care residents. We sought to characterize antimicrobial susceptibilities among urine isolates collected from women long-term care residents enrolled in a clinical trial across 21 long-term care facilities in Connecticut, United States of America between August 2012 and October 2015. Among 967 urine cultures collected from 175 women long-term care residents with and without suspected urinary tract infection, we identified 456 bacterial isolates. Escherichia coli (55.3%), Klebsiella (13.8%) and Enterococcus (8.3%) species were the predominant organisms identified. Among all 456 urine isolates, 68.1% were ciprofloxacin-susceptible, 77.2% were trimethoprim/sulfamethoxazole-susceptible, 86.3% were cefazolin-susceptible, and 72.6% were nitrofurantoin-susceptible. Among 252 Escherichia coli urine isolates, 60.2% were ciprofloxacin-susceptible, 73.7% were trimethoprim/ sulfamethoxazole-susceptible, 84.5% were cefazolin-susceptible, and 86.5% were nitrofurantoin-susceptible. These findings suggest that trimethoprim/sulfamethoxazole may be favorable empiric therapy while the urinary isolate is unknown, and nitrofurantoin may be optimal therapy for uncomplicated urinary tract infection due to Escherichia coli in women long-term care residents.


Antibiotic Susceptibility; Escherichia coli; Long-Term Care Residents; Nitrofurantoin; Urinary Tract Infection

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