Risk factors and treatment of urinary tract infections in elderly people

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.