[Direct antibiotic sensitivity testing in the treatment of urinary tract infections in a nursing home]

Urinary tract infections occur frequently in nursing homes. Treatment is usually empiric without microbiological investigation. Because there is widespread resistance to the most frequently used antibiotics, we tested a relatively simple method (direct sensitivity testing for 7 antibiotics) to get information about the antibiotic resistance. The results, with 49 urine samples in the evaluation, showed a concordance of our direct sensitivity test with conventional culture (the golden standard) of 89.8% (35/342 evaluations were not in concordance). The concordance for the result 'sensitive' was 98.8% (3/240 results showed 'false-sensitive'), and the the result 'resistant' 68.6% (32/342 results showed 'false-resistant'). Urinary tract infections in the nursing home can be treated more quickly and more adequately with antibiotics with the information obtained by direct sensitivity testing. This method can be recommended as an alternative to empiric treatment.