Management of urinary tract infections in the nursing home elderly: a proposed algorithmic approach

Predictors of outcome in geriatric patients with urinary tract infections

“…Additionally, this subgroup may have increased morbidity compared with all elderly patients, as the study patients had a higher rate of hospital admission than the other geriatric ED patients. Older patients are at increased risk for complicated UTIs secondary to decreased mobility (empty bladder less frequently), incomplete bladder emptying (enlarged prostate, neuropathic), increased perineal soiling, decreased estrogen (alters genitourinary [GU] mucosal barrier), GU instrumentation, and decreased mental status (21,22). The rates of mortality (6.3%) and ICU admission (13.2%) for hospitalized patients in this study are lower but comparable to those reported for hospitalized pneumonia patients in the same age group (10.6% and 22.4%, respectively) (23).…”

Managing Urinary Tract Infections in Nursing Homes: A Qualitative Assessment

“…The factors influencing this high prevalence include immobility which leads to incomplete bladder emptying, poor hygiene, which favours bacterial growth 1 , and age-associated physiological changes, together with co-morbidities such as incontinence 2,3 . Nevertheless, the majority of nursing home residents with a UTI do not show symptoms of an infection; they are referred to as asymptomatic 4 .…”

Optimizing antibiotics in residents of nursing homes: protocol of a randomized trial

“…A management algorithm for UTIs in nursing homes has been proposed [34]. However, no algorithms for optimizing antimicrobial use or for managing infections have been evaluated in LTCFs.…”