Higher levels of antibiotic resistance in aged care facilities

New research shows higher levels of antibiotic resistance are present in aged care facilities during the treatment of urinary tract infections caused by E. coli.

The study from the University of New South Wales compared cases within aged care and those collected from within hospitals and the wider community. Researchers analysed the pathogen composition and corresponding antibiotic resistance of 775,559 UTI samples from across NSW. These samples were collected from communities via GPs, hospitals and aged care facilities before and during the COVID-19 pandemic.

Published in the journal Open Forum Infectious Diseases, the study also found that antibiotic resistance in UTIs reduced over the course of the COVID-19 pandemic.

In Australia there have been recent reports of increasing local rates of antibiotic resistance. Associate Professor Li Zhang from UNSW’s School of Biological and Biomedical Sciences (BABS), who led the study, wanted to see how antibiotic resistance was impacting UTI treatment.

Results from this latest study provide valuable insights for medical professionals in effectively managing UTIs and for the relevant Australian authorities in formulating antibiotic treatment approaches of UTIs.

“We believe this is a really important element to be considered in the treatment of those who are affected by UTIs,” Zhang said.

Antimicrobial resistance is considered one of the most important threats to modern medicine by the World Health Organisation. In the case of UTIs, antibiotic resistance is associated with delayed symptom resolution, which can increase the chance of kidney infections.

“In each country, there are various recommended antibiotics for treating UTIs,” Zhang said.

“Recommendations are usually based on the local antibiotic resistant pattern. And for this reason, it’s important that antibiotic resistant patterns are continuously measured and analysed.”

Recommendations on UTI management are regularly updated by various health authorities and scientific societies, and in turn, this can influence policy. For example, recent changes to UTI treatments have been made in France and the UK in response to managing changing antibiotic resistance.

This latest study has provided useful insight into the treatment landscape of UTIs in Australia.

“This data may be a worthwhile tool to help clinicians and policymakers evaluate whether trimethoprim is still the most appropriate antibiotic for the first line treatment of UTIs,” said Alexandra Young, one of the study authors.

“While there are many factors to consider when making treatment recommendations, antibiotic resistance is definitely a key element.

“As well as affecting older people, the burden of UTIs also falls heavily on women. UTIs can have a huge impact on people’s health and quality of life, so it’s important that challenges like antibiotic resistance are addressed.”

Next, the team want to identify exactly where the different pathogens have come from, and why E. coli bacteria in aged care facilities tend to have the highest rate of resistance to trimethoprim.

“Is it because older people in aged care facilities have visited hospitals and acquired the resistant UTI there? Or is it because antibiotic resistant strains are circulating in the aged care facility itself?” Zhang said.

“The more we know, the better we can devise strategies to control or reduce this antibiotic resistance.”

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