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Published on: December 1, 2017
[Urinary tract infections in the elderly]
Klaus Friedrich Becher1, Ingo Klempien2, Andreas Wiedemann3
1Abteilung Geriatrie und Frührehabilitation, HELIOS Hanseklinikum Stralsund, Große Parower Straße 47-54, 18437, Stralsund, Deutschland. klaus.becher@helios-kliniken.de.
Abstract:
Acute infection of the urinary tract is one of the most commonly encountered bacterial infections in the frail elderly population and is responsible for substantial morbidity and recurrent infections with antibiotic resistance. Although generally considered to be self-limiting without treatment or easily treated with a short antibiotic regime, urinary tract infections (UTIs) often have a dramatic history, associated with incomplete resolution and frequent recurrence. The biological complexity of the infections combined with a dramatic rise in antibiotic-resistant pathogens highlight the need for an anticipating strategy for therapy necessary for a rapid recovery. The first crucial step is the classification in asymptomatic bacteriuria or complicated pyelonephritis, on which the decision for the intensity of treatment and diagnostic effort is based. For the selection of empiric antibiotic therapy, knowledge about the predominant uropathogens as well as local resistance patterns is important. In this manner, most urinary tract infections in the elderly can be treated without greater expense.
Insights
Urinary tract infections (UTIs) in the elderly often recur and resist antibiotics. An anticipating strategy, classifying infections and knowing local resistance patterns, is crucial for effective, rapid recovery.
Area of Science:
- Geriatric Medicine
- Infectious Diseases
- Bacteriology
Context:
- Acute urinary tract infections (UTIs) are common in the frail elderly.
- These infections cause significant morbidity and recurrent episodes, often with antibiotic resistance.
- UTIs in the elderly can be complex, leading to incomplete resolution and frequent recurrence.
Purpose:
- To highlight the need for an anticipating therapeutic strategy for UTIs in the elderly.
- To emphasize the importance of classifying UTIs (asymptomatic bacteriuria vs. complicated pyelonephritis) for treatment decisions.
- To underscore the necessity of understanding uropathogen prevalence and local resistance patterns for empiric antibiotic selection.
Summary:
- Effective management of UTIs in the elderly requires a strategic approach.
- Classification of infection type guides diagnostic and treatment intensity.
- Knowledge of local uropathogen resistance patterns is vital for selecting appropriate empiric antibiotic therapy.
Impact:
- Facilitates more rapid recovery from UTIs in elderly patients.
- Aims to reduce morbidity and the incidence of recurrent, antibiotic-resistant infections.
- Enables cost-effective treatment of most UTIs in this vulnerable population.
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Urinary tract infections (UTIs) are one of the most common urinary system disorders. They are caused by bacteria that enter the urethra and can spread to the bladder resulting in cystitis. Pyelonephritis is the result of a UTI that has ascended to the level of the...