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Enterococcus behind many UTIs in elderly; Tx resistance rises with age.(Gynecology)
SAN FRANCISCO -- The culprit behind most noncomplicated urinary tract infections in outpatients--Escherichia coli--plays less of a role as patients age, a study of 2,751 urine cultures showed.
Other pathogens, particularly enterococcus, played a greater role in urinary tract infections (UTIs) in older patients, and the rates of antibiotic-resistant enterococcus increased in older patients, David J. Blehar, M.D., said at the annual meeting of the American College of Emergency Physicians.
The prospective study of serial cases from 80 outpatient offices and four emergency departments divided adult patients into five age groups and looked at the pathogens responsible for UTIs and their susceptibility to antibiotic treatment.
In the youngest group, 18- to 40-year-olds, E. coli caused more than 75% of UTIs, a finding similar to previous estimates that E. coli causes 75%-90% of UTIs overall. The role of E. coli fell with increasing age, however, with a proportional increase in other pathogens. In patients older than 80 years, E. coli accounted for fewer than half of UTIs, but enterococcus caused up to 20% of UTIs, said Dr. Blehar of the University of Massachusetts, Worcester.
The study looked at rates of resistance to four antibiotic therapies. ...
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