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Bacteriuria and urinary infections in the elderly

S J Childs1, R J Egan

  • 1University of Colorado Health Sciences Center, Denver USA.

The Urologic Clinics of North America
|February 1, 1996
PubMed
Summary

Aging increases infection susceptibility, particularly urinary tract infections (UTIs) in elderly women due to hormonal changes and catheter use. Treatment should focus on symptomatic UTIs to prevent antimicrobial resistance.

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Area of Science:

  • Gerontology
  • Infectious Diseases
  • Urology

Background:

  • Aging impairs physiological homeostasis, increasing susceptibility to infections.
  • Hospitalization and medical procedures in the elderly, like catheterization, elevate infection risk, especially from antimicrobial-resistant uropathogens.
  • Postmenopause leads to decreased estrogen, reduced vaginal lactobacilli, and increased susceptibility to bacteriuria in elderly women.

Purpose of the Study:

  • To review the challenges and considerations for managing urinary tract infections (UTIs) in the elderly population.
  • To highlight the increased risk of UTIs in elderly individuals, particularly women, and the factors contributing to it.
  • To discuss the complexities of antimicrobial selection for UTIs in older adults.

Main Methods:

  • Literature review focusing on aging, infection susceptibility, and urinary tract infections in the elderly.
  • Analysis of factors contributing to increased UTI incidence in elderly women postmenopause.
  • Examination of the rationale for treating only symptomatic bacteriuria to mitigate antimicrobial resistance.

Main Results:

  • Elderly individuals are more prone to infections due to decreased physiological functioning.
  • Catheterization and polymicrobial infections in drainage bags facilitate antimicrobial resistance.
  • Elderly women have a higher incidence of bacteriuria compared to men, partly due to postmenopausal changes.

Conclusions:

  • Asymptomatic bacteriuria in the elderly should not be treated to prevent antimicrobial resistance.
  • Symptomatic UTIs in the elderly require careful antimicrobial selection due to physiological and environmental factors.
  • There is insufficient data on the efficacy and safety of antimicrobial agents for treating symptomatic UTIs in the elderly.

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