Abstract
PurposeBacterial urinary tract infections (UTIs) are the most frequently occurring infectious diseases in the geriatric population. The aim of the study was to determine the prevalence and clinical features of UTIs in geriatric in-patients and their association with health and functional ability characteristics.MethodsA prospective cross-sectional cohort study was conducted among patients hospitalized on the geriatric ward. Patients were interviewed, examined, and had their hospital records analyzed. An uncontaminated midstream urine sample was collected and cultured in all of the cases suspected for UTI. Relative risks for UTI were counted and multivariable logistic regression model was built.Results246 patients were included, 179 (72.8%) women, 210 (85.4%) 75 + -year-olds. Bacterial UTIs occurred in 18.3% of the patients. The main etiological agent was Escherichia coli (73.3%). The most significant predictors of UTI were recurrent UTI and urinary catheter. The typical clinical UTI symptoms occurred in less than half of the cases (only in 11.1% of cases fever was observed). More often, than in patients without UTIs, they reported symptoms such as delirium (28.9% vs. 18%), tachycardia (11.1% vs. 1.5%) or hypotension (20% vs. 12.1%).ConclusionsBacterial UTIs affect about 1/5 of hospitalized geriatric patients. The clinical picture of these infections very often is atypical and it indicates a need for diagnostic vigilance.
Highlights
IntroductionSeveral factors (including co-morbidity, malnutrition, immune senescence and social health-related factors) result in an increased incidence of infections in older adult individuals
Several factors result in an increased incidence of infections in older adult individuals
The majority of patients are admitted in a planned manner, but some patients are admitted in an accelerated mode, most often transferred from other hospital departments, or after a telephone consultation with a patient’s family doctor confirming such a need
Summary
Several factors (including co-morbidity, malnutrition, immune senescence and social health-related factors) result in an increased incidence of infections in older adult individuals. These can be important predictors for worse outcomes [1]. The quite frequent problems in communication with a geriatric patient (due to deafness, neurological diseases or cognitive deterioration) make it difficult to conduct a reliable examination and obtain reliable information on the signs and symptoms of UTI. Such patients require a comprehensive geriatric evaluation. Difficulties may concern obtaining urine for examination, for example in the case of accompanying delirium
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