Urinary tract infections in the elderly: a review of disease characteristics and current treatment options

Abstract

Urinary tract infections (UTIs) are common in the elderly, and cover a range of conditions from asymptomatic bacteriuria to urosepsis. Risk factors for developing symptomatic UTIs include immunosenescence, exposure to nosocomial pathogens, multiple comorbidities, and a history of UTIs. European guidelines on urological infections recommend antimicrobial treatment only for symptomatic UTIs. Non-antimicrobial options to treat and prevent UTIs include among others cranberry products, OM-89 Escherichia coli bacterial lysate vaccine, and estrogen therapy in postmenopausal women, although evidence for their efficacy is weak. Another non-antimicrobial option to control and prevent UTIs is a medical device (Utipro Plus ® ) containing xyloglucan, gelatin, propolis, and extracts of Hibiscus sabdariffa . The device acts in the intestine as a mechanical barrier to protect against invasion by uropathogenic E. coli strains. A randomized controlled trial of Utipro Plus ® in patients with uncomplicated UTIs provided good-quality evidence of its efficacy compared with placebo. In an observational study of Utipro Plus ® in patients with recurrent UTIs, more than 80% women reported a return to their pre-UTI clinical status and about 30% transitioned from symptomatic UTIs to asymptomatic bacteriuria. New treatment strategies that offer a safe and effective non-antimicrobial means of managing UTIs could have an important role in the elderly.

Heterogeneity of Antibiotics Multidrug-Resistance Profile of Uropathogens in Romanian Population

“…A high quota was observed in seniors between 60–69 years old, representing 24.73% in females and 30.07% in males, with a peak of incidence in patients over 70 years old—48.28% in the overall population. It has been shown that multiple risk factors are associated with the prevalence of UTIs in the elderly male population, such as prostate enlargement, urolithiasis, urinary tract neoplasia, renal failure, or urethral strictures [ 14 , 15 ].…”

Species distribution of Enterobacteriaceae and non-Enterobacteriaceae responsible for urinary tract infections at the Zainoel Abidin Hospital in Banda Aceh, Indonesia

“…The incidence of UTI increases in patients aged 40 years and over with the highest peak in the 50-59year age group in long-term care facilities and communities (Matthews and Lancaster 2011). Several predisposing factors cause UTI in elderly people, including prostate problems in men, postmenopausal estrogen deficiency in women, exposure to nosocomial pathogens, and comorbidities such as diabetes mellitus is widely associated with an increased incidence of UTI (Ahmad et al 2020;Rodriguez-Mañas 2020). In terms of gender, similar to previous findings by Kurniawati and Auliyanah (2021), women are more likely to have urinary tract infections compared to men in all age groups.…”

Management of proximal femur fractures in the elderly: current concepts and treatment options

“…With age, the incidence of urinary tract infections increases [ 34 ]. In addition to symptomatic urinary tract infections, asymptomatic bacteriuria is common among the elderly.…”