By M. Pana

ISBN-10: 9535104721

ISBN-13: 9789535104728

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4. Antibiotic resistance Because infections occur frequently in nursing homes, residents are exposed to antimicrobial agents (Nicolle LE & Al, 1984, 1996; Finnegan TP & Al, 1985; Magaziner J & Al, 1991; Jackson M & Al, 1992). With mostly broad-spectrum antibiotics available and in wide use, resistance problems has been repeatedly documented since the early 1970s. Indeed, numerous studies based on routine surveillance data, indicate a strong relationship between use and resistance (van de Sande-Bruinsma N & Al, 2008) but, nowadays, the epidemiology of antimicrobial resistance in nursing homes remains poorly understood (Lautenbach E & Al, 2009).

Chronic genitourinary symptoms are also common but are not attributable to bacteriuria (Nicolle LE & Al, 2005a; Ouslander JG & Schnelle JF, 2005). Because the prevalence of bacteriuria is high, a positive urine culture, with or without pyuria, is not sufficient to diagnose urinary infection (Nicolle LE & Al, 2005a). Clinical findings for diagnosis of urinary tract infection in non-catheterized residents must include some localization to the genitourinary tract (Mc Geer & Al, 1991). The diagnosis also requires a positive quantitative urine culture obtained by the clean-catch voided technique, by in and out catheterization, or by aspiration through a catheter system sampling port.

Local external care is required. The reported microbiology of symptomatic urinary tract infections in nursing homes shows that E. coli in women, and Proteus Mirabilis in men are the most frequently isolated infecting organisms (Nicolle LE & Al, 1987; 1996; Ricci G & Al, 2010). Gram-negative 30 Antibiotic Resistant Bacteria – A Continuous Challenge in the New Millennium organisms of increased antimicrobial resistance, including Klebsiella pneumoniae, Providencia spp, Morganella morganii, Enterobacter spp, Citrobacter spp and Pseudomonas aeruginosa are frequently isolated (Nicolle LE & Al, 1987; 1996; Ricci G & Al, 2010).

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Antibiotic Resistant Bacteria - A Contin. Chall. in the New Millenn. by M. Pana

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