Urinary Tract Infections Among Geriatric Patients: A Systematic Review

Abstract

Urinary tract infection (UTI) is the second most popular infection in the geriatric community, and the first popular is urine and fecal incontinence. Because of the effects of immunological aging, elderly are more susceptible to bacterial microorganisms and viral infections. The disease ranges from relatively harmless cystitis to potentially fatal pyelonephritis. This article aims to discuss the epidemiology, diagnosis, risk factors, progress of the disease, causative microorganisms, and guidelines for drug management of UTIs in geriatric patients. This study was performed following the PRISMA checklist. PubMed (2016-2022), Biological Sciences (ProQuest) (2012-2022), and ScienceDirect were used to locate English-language literature (2018-2022). We extracted data to assess the epidemiology, diagnosis, risk factors, causative microorganisms, and treatment management of UTIs in geriatric patients. This systematic review encompassed 11 observational studies including a total of 945,908 elderly patients and were published between 2012 and 2022. The prevalence varies across the studies. Urinary catheterization, gender, polypharmacy, comorbidities especially diabetes mellites older age, dementia, older age, vaginitis, previous history of UTI, bedridden state, and antimicrobial use were the independent risk factors. E. coli was the most found causative agent. Antibiotics were given specifically for UTIs. Despite the high rate of risk factors and prevalence of UTIs in the geriatric, treatment options are minimal. There is no evidence to support the use of antibiotics for long-term UTI prevention. However, alternative prophylaxis methods for patients with recurring infections must be developed. Although further studies are required to properly understand the clinical features and treatment modalities in elderly patients within the community or under institutional care.