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Bacterial resistance to trimethoprim in geriatric medical wards

M J Bendall1, S Ebrahim, R G Finch

  • 1Department of Health Care of the Elderly, University of Nottingham Medical School, UK.

Gerontology
|January 1, 1989
PubMed

Insights

Trimethoprim-resistant urinary tract infections (UTIs) are common in geriatric wards, particularly in males. Faecal carriage of resistant organisms is linked to UTIs, with antimicrobial exposure being a key factor.

Area of Science:

  • Geriatric Medicine
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Urinary tract infections (UTIs) are a significant health concern in elderly populations.
  • Trimethoprim (TMP) resistance in UTI pathogens complicates treatment options.
  • Faecal carriage of antimicrobial-resistant organisms is a reservoir for infection.

Purpose of the Study:

  • To investigate the prevalence of TMP-resistant UTIs in geriatric wards.
  • To identify risk factors associated with TMP-resistant UTIs and faecal carriage.
  • To determine the relationship between faecal carriage and TMP-resistant UTIs.

Main Methods:

  • Study conducted in two geriatric wards.
  • Assessed prevalence of TMP-resistant UTIs and faecal carriage.
  • Analyzed associations with patient demographics, admission types, and length of stay.
  • Evaluated the impact of antimicrobial exposure on faecal carriage.

Main Results:

  • TMP-resistant UTIs were prevalent (26% on admission, 50% ward-acquired).
  • Risk factors included male sex, recurrent admissions, transfers, and longer hospital stays.
  • A strong correlation was observed between faecal carriage and TMP-resistant UTIs.
  • Antimicrobial exposure was identified as the primary determinant of TMP-resistant faecal carriage.

Conclusions:

  • TMP-resistant UTIs pose a substantial challenge in geriatric care.
  • Faecal carriage serves as a significant reservoir for TMP-resistant UTIs in this setting.
  • Minimizing antimicrobial exposure is crucial to control the spread of TMP resistance.

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