scholarly journals Risk factors and treatment of urinary tract infections in elderly people

2014 ◽  
Vol 67 (suppl. 2) ◽  
pp. 9-13
Author(s):  
Radoslava Doder ◽  
Jelena Polovina ◽  
Nadica Kovacevic ◽  
Sinisa Sevic ◽  
Tomislav Preveden ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infectious Diseases ◽  
Asymptomatic Bacteriuria ◽  
The Elderly ◽  
Lumbar Region ◽  
Associated Diseases ◽  
Urinary Infections ◽  
Therapeutic Procedures ◽  
Tract Infections ◽  
Novi Sad

Introduction. The aim of the retrospective part of this research was to present the risk factors, etiology, clinical picture, therapy and outcome of urinary infections in elderly patients treated at the Department of Infectious Diseases in Novi Sad. The prospective part was aimed at establishing the most common risk factors for urinary infections among users in the Gerontology Center "Novi Sad? and determining the appropriate preventive measures by using an assessment questionnaire. Material and Methods. The retrospective research included 81 patients diagnosed with urinary infection. The patients were over 65 years of age and were treated at the Department of Infectious Diseases in the period from 2010 to September 2012. Within the prospective part of research, a poll was conducted among users of Gerontology Center ?Novi Sad? by applying an "Urination Disorder Test? questionnaire. Results. The average age of participants was 75.47 years (min 65, max 96, SD 6.86), and the female patients predominated in the patient population (F:M = 58%:42%). Associated diseases were recorded in 53 (65.4%) patients, and 24 (29.6%) of them had hypertension history. Escherichia coli were isolated in 12 (46.2%) patients. The majority of patients had preserved consciousness at admission whereas febrility and signs of intoxication were recorded in 60 (75.95%) and 33 (41.8%) patients, respectively. The patients reported the following problems: dysuria - 23 (29.1%) patients, pollakiuria - 9 (11.4%), suprapubic pain - 8 (10.1%) and pain in the lumbar region - 7 (8.9%) patients. Antibiotic therapy included ceftiaxone and ciprofloxacin, which were administered to 43 (56.6%) and 33 (43.3%) patients, respectively. Favorable disease outcome was recorded in 79 (97.5%) patients, whereas lethal outcome occurred in 2 (2.5%) patients and was associated with severe comorbidity. Frequent urinary infections, nocturia and incontinence, being the most frequent diseases among the users of Gerontology Center, were reported by 9 (22.5%), 25 (62.5%) and 16 (40%) users, respectively. The most frequent associated diseases were diabetes mellitus and therapeutic procedures on the prostate and bladder in 7 (17.5%) and stroke in 5 (12.5%) participants. Conclusion. Urinary infections in the elderly remain a highly challenging issue from both diagnostics and treatment standpoint. An update of guidelines to the relevant antimicrobial therapy is a prerequisite in order to decrease the uncritical administration of antibiotics in asymptomatic bacteriuria and to prevent the spreading of multiresistant organisms.

scholarly journals Utility of the blood culture in infection of the urinary tract with fever in the elderly

2021 ◽  
Author(s):  
Elisa Álvarez Artero ◽  
Amaia Campo Núñez ◽  
Moisés Garcia Bravo ◽  
Inmaculada García García ◽  
Moncef Belhassen Garcia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urine Culture ◽  
Urinary Infection ◽  
The Elderly ◽  
Blood Cultures ◽  
Febrile Urinary Tract Infection ◽  
Urinary Infections ◽  
Tract Infections ◽  
Overall Mortality

Introduction. Urinary tract infections are one of the most common community infections. The diagnosis of urinary infections in the elderly is complex because of its presentation and clinic. The aim of this article is to evaluate the usefulness of blood cultures in febrile urinary tract infection in elderly patients, risk factors, causes of discordance between urine and blood cultures, usefulness of biomarkers and mortality. Material and methods. Observational study of patients admitted over 65 years old, with urinary infections. Results. A total of 216 episodes with urinary infections and blood cultures performed. 70 (32,4%) cases with bacteremia. The most frequently detected isolates in blood cultures were: Escherichia coli 50 (71,4%) and Proteus spp. 6 (8,5%). Only septic shock was associated with a higher frequency of bacteraemia (OR=2,93, IC 95: 1,0-8,5; p=0,04). In 26 of the blood cultures a different isolation of the urine culture was detected. Overall mortality was 9.1%, with no association with the presence of bacteremia (p>0. 05). Conclusions. One third of elderly people hospitalized by tract urinary infection had bacteremia. Their detection was not associated with overall mortality. Disagree between blood and urine cultures in febrile is frequent, especially in patients with recent antibiotic treatment or recently hospitalized.

scholarly journals Urinary tract infections in pregnancy in a rural population of Bangladesh: population-based prevalence, risk factors, etiology, and antibiotic resistance

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Anne CC Lee ◽  
Luke C. Mullany ◽  
Alain K. Koffi ◽  
Iftekhar Rafiqullah ◽  
Rasheda Khanam ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Asymptomatic Bacteriuria ◽  
Population Based ◽  
E Coli ◽  
Maternal Undernutrition ◽  
Low Middle Income Countries ◽  
Tract Infections ◽  
In Pregnancy

Abstract Background Urinary tract infection (UTI) in pregnancy, including asymptomatic bacteriuria, is associated with maternal morbidity and adverse pregnancy outcomes, including preterm birth and low birthweight. In low-middle income countries (LMICs), the capacity for screening and treatment of UTIs is limited. The objective of this study was to describe the population-based prevalence, risk factors, etiology and antimicrobial resistance patterns of UTIs in pregnancy in Bangladesh. Methods In a community-based cohort in Sylhet district, Bangladesh, urine specimens were collected at the household level in 4242 pregnant women (< 20 weeks gestation) for culture and antibiotic susceptibility testing. Basic descriptive analysis was performed, as well as logistic regression to calculate adjusted odds ratios (aOR) for UTI risk factors. Results The prevalence of UTI was 8.9% (4.4% symptomatic UTI, 4.5% asymptomatic bacteriuria). Risk factors for UTI in this population included maternal undernutrition (mid-upper arm circumference <23 cm: aOR= 1.29, 95% CI: 1.03–1.61), primiparity (aOR= 1.45, 95% CI: 1.15–1.84), and low paternal education (no education: aOR= 1.56, 95% CI: 1.09–2.22). The predominant uro-pathogens were E. coli (38% of isolates), Klebsiella (12%), and staphyloccocal species (23%). Group B streptococcus accounted for 5.3% of uro-pathogens. Rates of antibiotic resistance were high, with only two-thirds of E. coli susceptible to 3rd generation cephalosporins. Conclusions In Sylhet, Bangladesh, one in 11 women had a UTI in pregnancy, and approximately half of cases were asymptomatic. There is a need for low-cost and accurate methods for UTI screening in pregnancy and efforts to address increasing rates of antibiotic resistance in LMIC.

scholarly journals Novel Biomarkers for the Diagnosis of Urinary Tract Infection–-A systematic Review

2009 ◽  
Vol 4 ◽  
pp. BMI.S3155 ◽  
Author(s):  
Neha Nanda ◽  
Manisha Juthani-Mehta
Keyword(s):  
Urinary Tract ◽  
Clinical Presentation ◽  
Asymptomatic Bacteriuria ◽  
Elevated Serum ◽  
The Elderly ◽  
Kidney Transplant Recipients ◽  
Pediatric Age Group ◽  
Cord Injury ◽  
Novel Biomarkers ◽  
Tract Infections

Urinary tract infections (UTIs) are associated with significant morbidity. We rely on clinical presentation, urinalysis, and urine culture to diagnose UTI. To differentiate between lower UTI and pyelonephritis, we depend on the clinical presentation. In the extremes of age and in immunocompromised individuals, clinical presentation is often atypical posing a challenge to diagnosis. In the elderly, the high prevalence of asymptomatic bacteriuria is another confounder. We conducted a search of publications to find novel biomarkers to diagnose UTI and to ascertain its severity. We searched PUBMED, MEDLINE and SCOPUS databases for studies pertaining to novel biomarkers and UTI. Two reviewers independently evaluated the methodology of the studies using the STARD (Standards for Reporting of Diagnostic Accuracy) criteria. We have identified procalcitonin as a biomarker to differentiate lower UTI from pyelonephritis in the pediatric age group. Elevated serum procalcitonin levels can result in early and aggressive treatment at the time of presentation. Interleukin 6 has also shown some promise in differentiating between lower UTI and pyelonephritis but needs further validation. Lastly, given the paucity of data in certain subgroups like diabetics, kidney transplant recipients, and individuals with spinal cord injury, further studies should be conducted in these populations to improve diagnostic criteria that will inform clinical management decisions.

scholarly journals Bacterial Etiology, Antibiotic Sensitivity Pattern and Risk Factors for Asymptomatic Bacteriuria during Pregnancy: Experience in a Tertiary Care Hospital

2017 ◽  
Vol 6 (2) ◽  
pp. 79-83
Author(s):  
Shakila Khanum ◽  
Jamal Uddin Ahmed ◽  
Khaleda Khanam
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Past History ◽  
Asymptomatic Bacteriuria ◽  
Antibiotic Sensitivity ◽  
Urine Samples ◽  
Successful Outcome ◽  
E Coli ◽  
History Of ◽  
Tract Infections

Background: Urinary tract infections (UTIs) are common during pregnancy. Untreated asymptomatic bacteriuria (ASB) during pregnancy may cause serious complications including pyelonephritis and delivery of premature or low-birth-weight infants. This study aimed to assess the risk factors for asymptomatic bacteriuria, bacterial agents and their antibiotic susceptibility pattern in pregnant women attending in Combined Military Hospital (CMH), Dhaka.Methods: This cross-sectional study was conducted in a total of 1540 pregnant women with no signs and symptoms of UTI from October 2013 to March 2015. Clean catch mid-stream urine samples were collected from all study participants using sterile containers. Urine samples were cultured using standard bacteriological methods. Identification of suspected colonies and antibiotic sensitivity testing were done. Patients having ASB were further evaluated to find out associated risk factors.Results: Out of 1540 pregnant women, 254 (16.5%) had asymptomatic bacteriuria (Colony forming unit >105/mL).The most frequently isolated bacteria were Escherichia coli (E. coli) (50.4%), followed by Klebsiella (24.0%). The antibiotic sensitivity rate of bacterial isolates were highest for imipenem and amikacin. Among different associated conditions, anemia (16.5%), gestational diabetes mellitus (GDM) (10%) and past history of UTI (5.1%) were found to be the most frequent factors associated with increased prevalence of ASB.Conclusion: In this study, the prevalence of ASB was high among pregnant women with anemia, GDM and past history of UTI. E. coli was the most common organism causing ASB, which is less susceptible to conventional oral antibiotics but more susceptible to imipenem and amikacin. So, careful drug selection is required for successful outcome in ASB.Birdem Med J 2016; 6(2): 79-83

Urinary tract infection

2019 ◽  
pp. 267-276
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Diagnostic Tests ◽  
Asymptomatic Bacteriuria ◽  
The Elderly ◽  
Drug Induced ◽  
Recurrent Uti ◽  
Clinical Presentations ◽  
Tract Infections

This chapter on urinary tract infections brings up to date advice on the aetiology, diagnosis, and management of urinary tract infections in adults. The microbiology of this common presentation is discussed, together with recent patterns of resistance. Different clinical presentations are highlighted: lower UTI, upper UTI, asymptomatic bacteriuria, pregnancy, catheterized patients, haematuria, the elderly, urethral syndrome, interstitial cystitis and drug-induced cystitis. The role of different diagnostic tests, in particular routine urine culture, is explored. Guidance on the management of different clinical presentations of UTI is given, as well as an outline of the options for reducing the frequency of recurrent UTI in those so predisposed.

scholarly journals Clinical Appraisal of Fosfomycin in the Era of Antimicrobial Resistance

2015 ◽  
Vol 59 (12) ◽  
pp. 7355-7361 ◽  
Author(s):  
Sangeeta Sastry ◽  
Lloyd G. Clarke ◽  
Hind Alrowais ◽  
Ashley M. Querry ◽  
Kathleen A. Shutt ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Clinical Outcomes ◽  
Tertiary Care ◽  
Asymptomatic Bacteriuria ◽  
Clinical Success Rate ◽  
Care Hospital ◽  
Content Type ◽  
E Coli ◽  
Number Of Patients ◽  
Tract Infections

ABSTRACTFosfomycin is recommended as one of the first-line agents for treatment of urinary tract infections (UTIs) in the latest guidelines endorsed by the Infectious Diseases Society of America (IDSA) and the European Society for Clinical Microbiology and Infectious Diseases (ESCMID). We evaluated the use of fosfomycin among inpatients at a tertiary care hospital between 2009 and 2013. UTI cases were defined using physician diagnosis and the National Healthcare Safety Network (NHSN) surveillance definitions. The number of patients treated with fosfomycin increased from none in 2009 to 391 in 2013. Among 537 patients who received fosfomycin for any indication during this period, UTI was the most common indication (74%), followed by asymptomatic bacteriuria (10%). All except 19 patients received a single dose of fosfomycin.Escherichia coliwas the most common organism involved (52%). For 119 patients with UTIs, after exclusion of those with negative urine culture results, negative urinalysis results, receipt of additional agents, or indeterminate clinical outcomes, the clinical success rate at 48 h was 74.8%. Of 89 patients who met the criteria for NHSN-defined UTIs, 89.9% had successful outcomes. Recurrent infections occurred in 4.3% of cases, and mild adverse events were observed in 2.0%. All 100 randomly selected extended-spectrum β-lactamase (ESBL)-producingE. coliclinical isolates from this period were susceptible to fosfomycin. In conclusion, the use of fosfomycin has increased substantially since implementation of the updated guidelines at this hospital. Fosfomycin was used mainly for the treatment of physician-diagnosed UTIs, and the clinical outcomes were generally favorable. Fosfomycin maintained activity againstE. colidespite the increased use of the agent.

scholarly journals Managing Recurrent Urinary Tract Infections in Women

2005 ◽  
Vol 1 (1) ◽  
pp. 39-50
Author(s):  
Lindsay E Nicolle
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Bacterial Infection ◽  
Postmenopausal Women ◽  
Urinary Tract Infections ◽  
Urinary Infection ◽  
Management Strategies ◽  
Recurrent Urinary Tract Infections ◽  
Urinary Infections ◽  
Tract Infections

Recurrent urinary infections are a common problem for women of all ages. Risk factors for urinary infection differ for pre- and postmenopausal women. Management strategies are well established, and include treatment of the acute symptomatic episode, and decreasing the frequency of subsequent episodes. This update focuses on the management of acute uncomplicated urinary infection, the most common bacterial infection in women.

Asymptomatic bacteriuria among the elderly living in the community: Prevalence, risk factors and characteristics

2012 ◽  
Vol 3 (2) ◽  
pp. 87-91 ◽  
Author(s):  
M. Varli ◽  
H. Guruz ◽  
S. Aras ◽  
A. Yalcin ◽  
T. Atli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Asymptomatic Bacteriuria ◽  
The Elderly ◽  
Elderly Living

scholarly journals Risk factors and predisposing conditions for urinary tract infection

2019 ◽  
Vol 11 ◽  
pp. 175628721881438 ◽  
Author(s):  
Oscar Storme ◽  
José Tirán Saucedo ◽  
Arturo Garcia-Mora ◽  
Manuel Dehesa-Dávila ◽  
Kurt G. Naber
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
High Risk ◽  
Bacterial Flora ◽  
Asymptomatic Bacteriuria ◽  
Blood Type ◽  
Quality Data ◽  
Primary Concern ◽  
Residual Urine ◽  
Tract Infections

Understanding individual and population-specific risk factors associated with recurrent urinary tract infections (UTIs) can help physicians tailor prophylactic strategies. Frequent intercourse, vulvovaginal atrophy, change of the local bacterial flora, history of UTIs during premenopause or in childhood, family history, and a nonsecretor blood type are substantiated risk factors for recurrent uncomplicated UTIs. This is a narrative review based on relevant literature according to the experience and expertise of the authors. Asymptomatic bacteriuria is generally benign; however, during pregnancy it is more common and is associated with an increased likelihood of symptomatic infection, which may harm the mother or fetus. Screening of pregnant women and appropriate treatment with antimicrobials must be balanced with the potential for adverse treatment-related outcomes; appropriate prophylaxis should be considered where possible. High-quality data are currently lacking on risks related to asymptomatic bacteriuria in pregnancy and further data in this hard-to-study population should be a primary concern for researchers. Incomplete voiding represents the primary risk factor for UTIs associated with conditions such as urinary incontinence and prolapse. Correcting the presence of residual urine remains the most effective prophylaxis in these populations. Bladder function alters throughout life; however, changes in function may be particularly profound in clinical populations at high risk of UTIs. Patients with neurogenic bladder will also likely have other evolving medical issues which increase the risk of UTIs, such as repeated catheterization and increasing residual urine volume. More aggressive antimicrobial prophylactic strategies may be appropriate in these patients. Again, the paucity of data on prophylaxis in these high-risk patients requires the attention of the research community.

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