Evde bakım ve Palyatif Bakım Hastalarının İdrar Kültürlerinin Karşılaştırılması; Kesitsel Çalışma

Abstract

Background/Aims : Urinary tract infections are an important cause of mortality, especially in geriatric patients. The effectiveness of urine culture and appropriate antibiotic use in geriatric patients followed in primary care is unknown. We aimed to compare the urine cultures and antibiotic susceptibility of patients over the age of 65 who were treated at home by the Home Health Services (ESH) and inpatients in the Palliative Care Service (PBS). Methods: Our study retrospectively compared the culture-antibiogram results of urine samples of patients aged 65 years and older with urinary infection complaints and followed and treated by PBS and ESH between January 1, 2019 and January 1, 2020. Results: Of the 60 patients included in the study, 30 had PBS, 30 ES Services patients had a mean age of 78.0±12.7 years, and PBS patients had a mean age of 80.7±9.8 years. According to the culture-antibiogram results of the urine samples of the patients, E.coli was the most common microorganism in both groups (p=0.003). When we look at the antibiotic sensitivity of the patients in the ESH group, Amikacin (96.7%), Cefoxitin (83.3%), Fosfomycin (73.3%), Nitrofurantoin (70%) sensitive and Ampicillin (76.7%) Cefuroxime (36%) ,7) Ceftazidime(40%) was found resistant to Ciprofloxacin(33%). PBS group is sensitive to Amikacin(60%), Cefoxitin(23.3), Fosfomycin(23.3%), Nitrofurantoin(16.6%) and Ampicillin(40%), Cefuroxime(26.7%), Ceftazidime( 33.3% were found to be resistant to Ciprofloxacin(53.3%). In both groups, the highest resistance rates were found in Ampicillin, 76.7% in ESH patients and 40% in PBS patients, and the highest sensitivity rates were in Amikacin, 96.7% in ESR and 60% in PBS. Conclusion: In this study conducted over the age of 65, empirically in ESR in urinary system infections; on the other hand, it would be rational to use oral Fosfomycin or Nitrofurantoin or Amikacin; It is thought that due to high antibiotic resistance in PBS, caution should be exercised.