Abstract
Introduction. Nowadays the presence of bacteria in the urine is considered to be the normal condition, that became the foundation of the urinal microflora conception. The characteristics of the urine microflora depend on the region and general health of the population and may change in time. Aim. Our goal was to assess the characteristics of urinary microbiota among hospitalized long livers in comparison to the people of younger age groups living in Mari El Republic. Materials and methods. We used the standard bacteriological analysis of midstream free voiding urine and disc diffusion method. Statistical analysis was performed with the help of chi-square criteria. Totally, 720 hospitalized (during 2011-2018 years in Yoshkar-Ola hospital) patients were included into the analysis. Patients were divided into the three age groups: young (18-59 years old), elderly (60-89 years old), long-livers (90+ years old). Results and discussion. Probability of bacteria detection in the urine varied in the range 56,4% - 86,9% without difference between elderly and long-livers, however elderly and long-livers had significantly higher risk of bacteria detection in the urine compared to the young age group. In female long-livers we found only gram-negative bacteria, therefore the rate of gram-positive bacteria in the urine was significantly lower compared to the young age group (p=0,03). Males had stable rate of gram-positive bacteria in all three age groups. Escherichia coli (56,8%) was the most common potentially pathogenic bacteria found in the urine. The resistance rate to aminoglycosides among all bacteria was 13%, to fluorquinolones — 33,5%. Escherichia coli resistance to aminoglycosides was 9,6%, to fluorquinolones — 29,4%. Conclusion. Long-livers and elderly patients are characterized by the similar probability of bacteria detection in urine. Urine microflora of female long-livers contains no gram-positive bacteria. The prevalence of gram-positive bacteria in male long-livers was stable. Fluoroquinolones are not the drugs of choice for urine infection empiric therapy in our hospital due to the increased rate of resistance over the 10%. In contrast, aminoglycosides may be considered as a first-line empiric therapy. We found no increase of resistance rate among the long livers compared to the patients of younger age groups.
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