Browse > Article

Urinary tract infections in the elderly  

Wie, Seong-Heon (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Publication Information
The Korean Journal of Medicine / v.79, no.4, 2010 , pp. 335-345 More about this Journal
Abstract
The great increase in the numbers of the elderly people is one of the important challenges that our health care systems have to face and prepare. Many infectious diseases are more frequent in elderly persons, because of their decreased immune and physiologic functions. Elderly patients above the age of 65 are known to be at high risk for urinary tract infection. Urinary tract infection is the most common infection and also the first cause of bacteremia in the elderly. Most urinary tract infections in the elderly are either asymptomatic or mild and are easily managed. If left untreated, however, these infections can develop into severe and potentially life-threatening sepsis. Asymptomatic bacteriuria is neither the cause of morbidity nor associated with a higher mortality rate and thus treatment is not recommended. Older persons may not complain of typical urinary symptoms and usually have complicating factors including functional or structural abnormalities of the genitourinary tract. The epidemiology, pathogenesis, diagnosis and management of urinary tract infections in the elderly patients are discussed in this review according to their underlying diseases, sex, symptoms, and infection sites.
Keywords
Aged; Cystitis; Pyelonephritis; Indwelling catheter;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 Hedin K, Petersson C, Wideback K, Kahlmeter G, Molstad S. Asymptomatic bacteriuria in a population of elderly in municipal institutional care. Scand J Prim Health Care 20:166-168, 2002   DOI   ScienceOn
2 Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis 40:643-654, 2005   DOI   ScienceOn
3 Rodhe N, Lofgren S, Matusset A, Andre M, Englund L, Kuhn I, Mostad S. Asymptomatic bacteriuria in the elderly: high prevalence and high turnover of strains. Scand J Infect Dis 40:804-810, 2008   DOI   ScienceOn
4 Hustinx WN, Mintjes-de Groot AJ, Verkooyen RP, Verbrugh HA. Impact of concurrent antimicrobial therapy on catheter-associated urinary tract infection. J Hosp Infect 18:45-56, 1991   DOI   ScienceOn
5 Orr P, Nicolle LE, Duckworth H, Brunka J, Kennedy J, Murray D, Harding GK. Febrile urinary infection in the institutionalized elderly. Am J Med 100:71-77, 1996   DOI   ScienceOn
6 Ras Z, Schiller D, Nicolle LE. Chronic indwelling catheter replacement before antimicrobial therapy for symptomatic urinary tract infection. J Urol 164:1254-1258, 2000   DOI   ScienceOn
7 Tseng TY, Stoller ML. Obstructive uropathy. Clin Geriatr Med 25:437-443, 2009   DOI   ScienceOn
8 Boyko EJ, Chen CL, Fihn SD, Normand EH, Scholes D, Yarbro P. Diabetes and the risk of acute urinary tract infection among postmenopausal women. Diabetes Care 25;1778-1783, 2002   DOI   ScienceOn
9 Tal S, Guller V, Levi S, Bardenstein R, Berger D, Gurevich I, Gurevich A. Profile and prognosis of febrile elderly patients with bacteremic urinary tract infection. J Infect 50:296-305, 2005   DOI   ScienceOn
10 Nicolle LE. Urinary tract infections in the elderly. Clin Geriatr Med 25:423-436, 2009   DOI   ScienceOn
11 Grover ML, Bracamonte JD, Kanodia AK, Edwards FD, Weaver AL. Urinary tract infection in women over the age of 65: is age alone a marker of complication? J Am Board Fam Med 22: 266-271, 2009   DOI   ScienceOn
12 Lipsky BA. Urinary tract infections in men: epidemiology, pathophysiology, diagnosis, and treatment. Ann Intern Med 110: 138-150, 1989   DOI   ScienceOn
13 Nicolle LE. Asymptomatic bacteriuria in the elderly. Infect Dis Clin North Am 11:647-661, 1997   DOI   ScienceOn
14 Nicolle LE. Urinary tract infection in geriatric and institutionalized patients. Curr Opin Urol 12:51-55, 2002   DOI   ScienceOn
15 Nicolle LE. Urinary tract infections in long-term-care facilities. Infect Control Hosp Epidemiol 22:167-175, 2001   DOI   ScienceOn
16 Neal DE Jr. Complicated urinary tract infections. Uro Clin North Am 35:13-22, 2008   DOI   ScienceOn
17 Matsumoto T. Urinary tract infections in the elderly. Curr Urol Rep 2:330-333, 2001   DOI   ScienceOn
18 Nicolle LE. Urinary tract infection in diabetes. Curr Opin Infect Dis 18:49-53, 2005   DOI   ScienceOn
19 Najar MS, Saldanha CL, Banday KA. Approach to urinary tract infections. Indian J Nephrol 19:129-139, 2009   DOI   ScienceOn
20 Ksycki MF, Namias N. Nosocomial urinary tract infection. Surg Clin North Am 89:475-481, 2009   DOI   ScienceOn
21 Wood CA, Abrutyn E. Urinary tract infection in older adults. Clin Geriatr Med 14:267-283, 1998
22 Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 18:243-254, 2001   DOI   ScienceOn
23 Kunin CM. Urinary tract infections in females. Clin Infect Dis 18:1-10, 1994   DOI   ScienceOn
24 Nicolle LE. Asymptomatic bacteriuria in diabetic women. Diabetes Care 23:722-723, 2000   DOI   ScienceOn
25 Warren JW. Catheter-associated urinary tract infections. Int J Antimicrob Agents 17:299-303, 2001   DOI   ScienceOn
26 Nicolle LE. Catheter-related urinary tract infection. Drugs Aging 22:627-639, 2005   DOI   ScienceOn
27 Curns AT, Holman RC, Sejvar JJ, Owings MF, Schonberger LB. Infectious disease hospitalizations among older adults in the United States from 1990 through 2002. Arch Intern Med 165: 2514-2520, 2005   DOI   ScienceOn
28 Schaeffer AJ, Datta NS, Fowler JE Jr, Krieger JN, Litwin MS, Nadler RB, Nickel JC, Pontari MA, Shoskes DA, Zeitlin SI, Hart C. Chronic Prostatits Collaborative Research/chronic pelvic pain syndrome(CP/CPPS). Urology 60 Suppl 6:1-4, 2002
29 Gleckman R, Blagg N, Hibert D, Hall A, Crowley M, Pritchard A, Warren W. Acute pyelonephritis in the elderly. South Med J 75:551-554, 1982   DOI   ScienceOn
30 Gleckman R, Blagg N, Hibert D, Hall A, Crowley M, Pritchard A, Warren W. Community-acquired bacteremic urosepsis in the elderly patients: a prospective study of 34 consecutive episodes. J Urol 128:79-81, 1982   DOI
31 Cho SY, Bae WJ, Cho YH, Lee SJ. Clinical Characteristics and Treatment Results of Acute Bacterial Prostatitis. Infect Chemother 41:36-41, 2009   DOI
32 Wagenlehner FM, Weidner W, Sorgel F, Naber KG. The role of antibiotics in chronic bacterial prostatitis. Int J Antimicrob Agents 26:1-7, 2005   DOI   ScienceOn
33 Bundrick W, Heron SP, Ray P, Schiff WM, Tennenberg AM, Wiesinger BA, Wright PA, Wu SC, Zadeikis N, Kahn JB. Levofloxacin versus ciprofloxacin in the treatment of chronic bacterial prostatitis: a randomized double-blind multicenter study. Urology 62:537-541, 2003   DOI   ScienceOn
34 Oh CS, Cheon SH, Park RJ, Lee MS. The efficacy of oral levofloxacin in the treatment of patients with chronic prostatitis. Infect Chemother 37:99-103, 2005
35 Steward DK, Wood GL, Cohen RL, Smith JW, Mackowiak PA. Failure of the urinalysis and quantitative urine culture in diagnosing symptomatic urinary tract infections in patients with long term urinary catheters. Am J Infect Control 13:159-160, 1985
36 Weidner W, Schiefer HG, Krauss H, Jantos C, Friedrich HJ, Altmannsberger M. Chronic prostatitis: a thorough search for etiologically involved microorganisms in 1,461 patients. Infection 19 Suppl 3: S119-S125, 1991   DOI
37 Klahr S. Obstructive nephropathy. Intern Med 39:355-361, 2000   DOI   ScienceOn
38 Bishop MC. Urosurgical management of urinary tract infection. J Antimicrob Chemother 33 Suppl A:75-91, 1994   DOI
39 Krieger JN, Nyberg L Jr, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA 282:236-237, 1999   DOI   ScienceOn
40 Tambyah PA, Maki DG. The relationship between pyuria and infection in patients with indwelling urinary catheters. Arch Intern Med 160:673-682, 2000   DOI   ScienceOn
41 High KP, Bradley SF, Gravenstein S, Mehr DR, Quagliarello VJ, Richards C, Yoshikawa TT. Clinical practice guideline for the evaluation of fever and infection in older adult residents of long-term care facilities: 2008 update by the Infectious Diseases Society of America. J Am Geriatr Soc 57:375-394, 2009   DOI   ScienceOn
42 Warren JW, Muncie HL Jr, Hall-Craggs M. Acute pyelonephritis associated with bacteriuria during long-term catheterization: a prospective, clinicopathological study. J Infect Dis 158:1341-1346, 1988   DOI   ScienceOn
43 Rudman D, Hontanosas A, Cohen Z, Mattson DE. Clinical correlates of bacteremia in a Veterans Administration extended care facility. J Am Geriatr Soc 36:726-732, 1988   DOI
44 Tambyah PA, Maki DG. Catheter-associated urinary tract infection is rarely symptomatic: a prospective study of 1497 catheterized patients. Arch Intern Med 160:678-687, 2000   DOI   ScienceOn
45 Warren JW, Damron D, Tenney JH, Hoopes JM, Deforge B, Muncie HL Jr. Fever, bacteremia and death as complications of bacteriuria in women with long-term urethral catheters. J Infect Dis 155:1151-1158, 1987   DOI   ScienceOn
46 Kim ME, Ha US, Cho YH. Prevalence of antimicrobial resistance among uropathogens causing acute uncompllicated cystitis in female outpatients in South Korea: a multecentre study in 2006. Int J Antimicrob Agents 31S:S15-S18, 2008
47 Gleckman R, Blagg N, Hibert D, Hall A, Crowley M, Pritchard A, Warren W. Acute pyelonephritis in the elderly. South Med J 75:551-554, 1982   DOI   ScienceOn
48 Truzzi JC, Almeida FM, Nunes EC, Sadi MV. Residual urinary volume and urinary tract infection--when are they linked? J Urol 180:182-185, 2008   DOI   ScienceOn
49 Omli R, Skotnes LH, Mykletun A, Bakke AM, Kuhry E. Residual urine as a risk factor for lower urinary tract infection: a 1-year follow-up study in nursing homes. J Am Geriatr Soc 56:871-874, 2008   DOI   ScienceOn
50 Saint S, Chenoweth CE. Biofilms and catheter-associated urinary tract infections. Infect Dis Clin North Am 17:411-432, 2003   DOI   ScienceOn